Impact of Metformin Use on Survival in Patients Undergoing Liver Resection for Colorectal Cancer Metastases

Kaltenmeier, Christof; Morocco, Brittany; Yazdani, Hamza O.; Reitz, Katherine M.; Meyer, Kelley; Molinari, Michele; Geller, David A.; Tohme, Samer

doi:10.1177/00031348211060445

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…All data utilized for the meta-analysis can be located in Tables 1 and 2. A total of 19 studies (Garrett et al ., 2012; Lee et al , 2012; Cossor et al ., 2013; Spillane et al , 2013; Zanders et al , 2015; Mc Menamin Ú et al , 2016; Paulus et al , 2016; Zhu et al ., 2017; Al Omari et al ., 2018; Baglia et al ., 2019; Dulskas et al , 2019; Mafiana et al , 2019; Vernieri et al ., 2019; Huang et al ., 2020; Kaltenmeier et al ., 2021; Erkinantti et al ., 2022; Scarton et al ., 2022; Seo et al ., 2022; Tarhini et al , 2022) were identified, encompassing 41 832 participants, that assessed the correlation between metformin usage and prognostic-related outcomes. The study included 18 studies (Ng et al ., 2011; Lakha et al ., 2012; Nielsen et al , 2012; Cardwell et al , 2014; Krens et al ., 2014; Hoffmeister et al ., 2015; Shao et al ., 2015; Gray et al , 2016, 2017; Haukka et al , 2017; Lash et al ., 2017; Voorneveld et al ., 2017; Yokomichi et al ., 2017; Mafiana et al , 2019; Erkinantti et al ., 2022; Kim et al , 2022; Pourlotfi et al ., 2022) (including 382 441 participants) evaluating the association between statin use and prognostic-related outcomes.…”

Section: Resultsmentioning

confidence: 99%

Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis

Xu,

Che,

Liu

et al. 2024

European Journal of Cancer Prevention

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Background Metformin and statins are commonly used globally for the treatment of type 2 diabetes mellitus and dyslipidemia, respectively. Recently, multiple novel pathways have been discovered, which may contribute to the treatment of various types of cancer. Several meta-analysis studies have reported that the use of metformin or statins is associated with a lower risk of colon cancer compared to nonusers. In this study, our aim was to perform a meta-analysis and investigate the prognostic roles of these two medications in colon cancer. Methods To identify relevant articles, literature searches were performed in the PubMed and Web of Science databases using a combination of keywords related to metformin, statins and colon cancer prognosis until August 2023. The study utilized STATA 12.0 software (Stata Corporation, College Station, Texas, USA) to compute all the hazard ratios (HRs) and 95% confidence intervals (CIs) regarding the association between metformin or statin uses and prognostic-related outcomes. Results Our analysis revealed that the use of metformin was associated with a significantly lower overall mortality of colon cancer (HR = 0.63; 95% CI = 0.51–0.77; I 2 = 94.9%; P < 0.001), as well as lower cancer-specific mortality of colon cancer (HR = 0.68; 95% CI = 0.50–0.94; I 2 = 91.9%; P < 0.001). Similarly, the use of statins was also associated with a lower overall mortality of colon cancer (HR = 0.68; 95% CI = 0.60–0.78; I 2 = 93.8%; P < 0.001), as well as a lower cancer-specific mortality of colon cancer (HR = 0.74; 95% CI = 0.67–0.81; I 2 = 82.2%; P < 0.001). Conclusion Our meta-analysis study suggests that statins and metformin may have potential as adjuvant agents with significant benefits in the prognosis of colon cancer.

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Section: Resultsmentioning

confidence: 99%

Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis

Xu,

Che,

Liu

et al. 2024

European Journal of Cancer Prevention

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“…The patients on metformin showed longer OS in comparison to the non-metformin user group (72 months vs. 60 months, respectively) with an HR of 0.44. Also, a longer recurrence-free survival was reported in the metformin group (HR 0.44) at 49 months vs.33 months in the non-metformin users' group [23]. In addition, a retrospective study by Chu et al, conducted on 6222 type II diabetic CRC patients who underwent surgery from 2000 to 2012, assessed the effect of metformin on OS and liver metastasis risk.…”

Section: Discussionmentioning

confidence: 99%

Role of Metformin in the Management of Colorectal Cancer: A Systematic Review

Abdelhafeez,

Al Orabi,

Shawki

et al. 2023

Archives of Pharmaceutical Sciences Ain Shams University

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Colorectal cancer (CRC) is the second-leading cause of mortality and morbidity worldwide with multiple standard therapies that failed to improve outcomes. Metformin, an old, repurposed medication with pleiotropic effect in many cancers, arises as a possible treatment for CRC. This review aimed to assess the effect of metformin in addition to the treatment plan of CRC patients. To identify relevant studies, Google Scholar, PubMed, Egyptian Knowledge Bank (EKB), and clinical trial.gov were systematically searched. Pre-defined search keywords were used as "Metformin", "colorectal cancer", "randomized controlled trials", "interventional studies", and "observational studies". Only English-based trials that are in full text were included. A total of 19 studies with different therapeutic adjuvant treatment options were evaluated for metformin treatment effects in CRC. Randomized control trials and observational studies were the main interest of the review while preventive and pre-clinical studies including animals and cell lines were excluded. In conclusion, Most of the studies except a few showed promising results on overall survival (OS), disease-free survival, and relapse-free time for metformin use as treatment in CRC. Also, a reductive effect of metformin was shown in toxicities as oxaliplatin-induced peripheral neuropathy and poor prognostic features as vessel co-option vasculature in liver metastasis. Future clinical randomized controlled studies are essential to confirm these results.

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Body mass index–based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM

Chen

et al. 2022

EPMA Journal

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Currently colorectal cancer (CRC) is the third most prevalent cancer worldwide. Body mass index (BMI) is frequently used in CRC screening and risk assessment to quantitatively evaluate weight. However, the impact of BMI on clinical strategies for CRC has received little attention. Within the framework of the predictive, preventive, and personalized medicine (3PM/PPPM), we hypothesized that BMI stratification would affect the primary, secondary, and tertiary care options for CRC and we conducted a critical evidence-based review. BMI dynamically influences CRC outcomes, which helps avoiding adverse treatment effects. The outcome of surgical and radiation treatment is adversely affected by overweight (BMI ≥ 30) or underweight (BMI < 20). A number of interventions, such as enhanced recovery after surgery and robotic surgery, can be applied to CRC at all levels of BMI. BMI-controlling modalities such as exercise, diet control, nutritional therapy, and medications may be potentially beneficial for patients with CRC. Patients with overweight are advised to lose weight through diet, medication, and physical activity while patients suffering of underweight require more focus on nutrition. BMI assists patients with CRC in better managing their weight, which decreases the incidence of adverse prognostic events during treatment. BMI is accessible, noninvasive, and highly predictive of clinical outcomes in CRC. The cost–benefit of the PPPM paradigm in developing countries can be advanced, and the clinical benefit for patients can be improved with the promotion of BMI-based clinical strategy models for CRC.

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Impact of Metformin Use on Survival in Patients Undergoing Liver Resection for Colorectal Cancer Metastases

Cited by 3 publications

References 22 publications

Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis

Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis

Role of Metformin in the Management of Colorectal Cancer: A Systematic Review

Body mass index–based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM

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