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http://dx.doi.org/10.7314/APJCP.2015.16.2.595

Metformin Association with Lower Prostate Cancer Recurrence in Type 2 Diabetes: a Systematic Review and Meta-analysis  

Hwang, In Cheol (Department of Family Medicine, Gachon University Gil Medical Center)
Park, Sang Min (Department of Family Medicine and Biomedical Sciences, Seoul National University College of Medicine)
Shin, Doosup (Department of Education and Research, Seoul National University College of Medicine)
Ahn, Hong Yup (Department of Statistics, Dongguk University)
Rieken, Malte (Department of Urology, University Hospital Basel)
Shariat, Shahrokh F. (Department of Urology, Medical University of Vienna)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.16, no.2, 2015 , pp. 595-600 More about this Journal
Abstract
Background: Accumulating evidence suggests that metformin possesses anticarcinogenic properties, and its use is associated with favorable outcomes in several cancers. However, it remains unclear whether metformin influences prognosis in prostate cancer (PCa) with concurrent type 2 diabetes (T2D). Materials and Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception to April 16, 2014 without language restrictions to identify studies investigating the effect of metformin treatment on outcomes of PCa with concurrent T2D. We conducted a meta-analysis to quantify the risk of recurrence, progression, cancer-specific mortality, and all-cause mortality. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated. Publication bias was assessed by Begg's rank correlation test. Results: A total of eight studies fulfilled the eligibility criteria. We found that diabetic PCa patients who did not use metformin were at increased risk of cancer recurrence (RR, 1.20; 95%CI, 1.00-1.44), compared with those who used metformin. A similar trend was observed for other outcomes, but their relationships did not reach statistical significance. Funnel plot asymmetry was not observed among studies reporting recurrence (p=0.086). Conclusions: Our results suggest that metformin may improve outcomes in PCa patients with concurrent T2D. Well-designed large studies and collaborative basic research are warranted.
Keywords
Diabetes; metformin; prognosis; prostate cancer;
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