The Use of Metformin in Patients with Prostate Cancer and the Risk of Death

被引:39
作者
Bensimon, Leah [1 ,2 ]
Yin, Hui [1 ]
Suissa, Samy [1 ,3 ]
Pollak, Michael N. [2 ,4 ]
Azoulay, Laurent [1 ,4 ]
机构
[1] McGill Univ, Lady Davis Inst, Ctr Clin Epidemiol, Jewish Gen Hosp, Montreal, PQ H3T 1E2, Canada
[2] McGill Univ, Montreal, PQ H3T 1E2, Canada
[3] McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ H3T 1E2, Canada
[4] McGill Univ, Dept Oncol, Montreal, PQ H3T 1E2, Canada
基金
加拿大健康研究院;
关键词
PRACTICE RESEARCH DATABASE; RADICAL PROSTATECTOMY; DIABETIC-PATIENTS; MORTALITY; INFORMATION; VALIDATION; VALIDITY; MEN;
D O I
10.1158/1055-9965.EPI-14-0056
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Given the conflicting results from observational studies, we assessed whether the use of metformin after a prostate cancer diagnosis is associated with a decreased risk of cancer-specific and all-cause mortality. Methods: This study was conducted linking four databases from the United Kingdom. A cohort of men newly diagnosed with nonmetastatic prostate cancer with a history of treated type II diabetes, between April 1, 1998 and December 31, 2009, was followed until October 1, 2012. Nested case-control analyses were performed for cancer-specific mortality and all-cause mortality, in which exposure was defined as use of metformin during the time to risk-set. Conditional logistic regression was used to estimate adjusted rate ratios (RR) of each outcome with 95% confidence intervals (CI). Results: The cohort consisted of 935 men with prostate cancer and a history of type II diabetes. After a mean follow-up of 3.7 years, 258 deaths occurred, including 112 from prostate cancer. Overall, the post-diagnostic use of metformin was not associated with a decreased risk of cancer-specific mortality (RR, 1.09; 95% CI, 0.51-2.33). In a secondary analysis, a cumulative duration >= 938 days was associated with an increased risk (RR, 3.20; 95% CI, 1.00-10.24). The post-diagnostic use of metformin was not associated with all-cause mortality (RR, 0.79; 95% CI, 0.50-1.23). Conclusion: The use of metformin after a prostate cancer diagnosis was not associated with an overall decreased risk of cancer-specific and all-cause mortality. Impact: The results of this study do not support a role for metformin in the prevention of prostate cancer outcomes. (C) 2014 AACR.
引用
收藏
页码:2111 / 2118
页数:8
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