Use of Metformin to Treat Type II Diabetes Mellitus Improved Colorectal Cancer Prognosis-A Retrospective Observational Study

雙胍類降血糖藥對於患有糖尿病的大腸直腸癌患者的預後有幫助－回顧性觀察研究

李佳翰(Chia-Han Lee) ； 范仲維(Chung-Wei Fan) ； 曾文科(Wen-Ko Tseng) ； 游彥麟(Yen-Lin Yu)

《中華民國大腸直腸外科醫學會雜誌》 33卷3期 (2022/09) Pp. 126-136

https://doi.org/10.6312/SCRSTW.202209_33(3).11109

摘要

Purpose. There is conflicting evidence of the beneficial effect of metformin on survival in colorectal cancer (CRC) patients. We therefore performed a retrospective study to assess the association between use of metformin and outcomes of CRC patients with concomitant type 2 diabetes mellitus (T2DM). Methods. Patients diagnosed with CRC with concomitant T2DM between January 1, 2006, and December 31, 2015, were identified in the Chang Gung Research Database. Overall survival and CRC-specific survival were estimated using the Kaplan-Meier method, and cumulative risks were compared between groups using the log-rank test. Results. Atotal of 1673 T2DM patients with newly diagnosed CRC were included in this study. Overall survival was significantly higher in the metformin users than in the metformin non-users (hazard ratio [HR], 1.248; 95% CI, 1.1-1.415, p ＜ .001). In subgroup analysis, post-diagnosis metformin users had better overall survival (HR, 1.718; 95% CI, 1.446-2.042, p ＜ .001) and CRC-specific survival (HR, 1.489; 95% CI, 1.195-1.857, p ＜ .001) than metformin non-users. Conclusions. For T2DM patients with newly diagnosed CRC, the use of metformin had a protective effect on overall survival. Patients who began using metformin post-diagnosis also had significantly better overall survival and CRC-specific survival. These findings support the use of metformin as an adjuvant therapy for CRC.

關鍵字

Metformin ； Type II diabetes mellitus ； Colorectal cancer ； Prognosis

並列摘要

目的：雙胍類降血糖藥在之前的文獻都有提到對於大腸直腸癌病人的存活率有改善，但有一些文獻則認為沒有幫助。因此我們想運用長庚研究資料庫來探討雙胍類降血糖藥對於患有糖尿病的大腸直腸癌患者的預後是否有所幫助。方法：我們運用長庚研究資料庫，擷取從2006年1月1日到2015年12月31日診斷大腸直腸癌同時有第二型糖尿病的患者來進行分析。收集包含病患性別、年齡、身體質量指數、腫瘤期別、共病性。雙胍類降血糖藥使用定義為六個月內至少服用兩次以上的處方。最後分析有使用藥物和沒使用藥物兩組病患的整體存活率和癌症特異性存活率。結果：研究結果顯示，我們收錄了1673名病患，有使用雙胍類降血糖藥的病患其整體存活率較沒使用的好。在分組分析之下，診斷大腸直腸癌之後才開始使用雙胍類降血糖藥的病患，其整體存活率和大腸直腸癌存活率都比沒使用的患者好。結論：我們的研究證實雙胍類降血糖藥對於大腸直腸癌同時有第二型糖尿病的患者的存活率是有幫助的，尤其是大腸直腸癌診斷後的持續使用。

並列關鍵字

雙胍類降血糖藥 ； 第二型糖尿病 ； 大腸直腸癌 ； 預後