AUTHOR=Yao Kui , Zheng Heng , Li Tao 

TITLE=Association Between Metformin Use and the Risk, Prognosis of Gynecologic Cancer

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.942380

DOI=10.3389/fonc.2022.942380

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>For gynecological cancer patients, the beneficial effect of metformin use remains controversial due to inconsistent results of published articles. By conducting a meta-analysis, we aimed to evaluate the effect of metformin in reducing the risk and improving the survival of gynecological cancer among women with diabetes mellitus (DM).</p></sec><sec><title>Methods</title><p>Articles exploring association between metformin use and the risk, as well as prognosis of gynecologic cancer in DM, were searched in the databases: PubMed, Web of Science, SCOPUS, EMBASE, EBSCO, and PROQUEST. Articles were published before May 2022. All the studies were conducted using STATA 12.0 software.</p></sec><sec><title>Results</title><p>The meta-analysis showed no significant association between metformin use and risk of gynecologic cancer in DM with a random effects model [odds ratio (ORs)/relative risk (RR) = 0.91, 95% confidence intervals (CI) 0.77 to 1.08, I<sup>2</sup> = 84.2%, <italic>p</italic> &lt; 0.001]. Metformin use was associated with reduced overall survival (OS) and progression-free survival (PFS) of gynecologic cancer in DM with random effects models [OS: hazard ratio (HR) = 0.60, 95% CI 0.49–0.74, I<sup>2</sup> = 55.2%, <italic>p</italic> = 0.002; PFS: HR = 0.55, 95% CI 0.33–0.91, I<sup>2</sup> = 69.1%, <italic>p</italic> = 0.006], whereas no significant association was showed between metformin use and recurrence-free survival (RFS), as well as cancer-specific survival (CSS) of gynecologic cancer in DM with random effects models (RFS: HR = 0.60, 95% CI 0.30–1.18, I<sup>2</sup> = 73.7%, <italic>p</italic> = 0.010; CSS: HR = 0.78, 95% CI 0.43–1.41, I<sup>2</sup> = 72.4%, <italic>p</italic> = 0.013).</p></sec><sec><title>Conclusions</title><p>In conclusion, this meta-analysis indicated that metformin may be a useful adjuvant agent for gynecological cancer with DM, especially for patients with ovarian cancer and endometrial cancer.</p></sec>