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Metformin Not Protective Following Prostate Cancer Surgery in Patients With Diabetes
Jun 13, 10 Clinical UpdatesThe use of metformin in patients with diabetes undergoing prostate cancer surgery did not appear to play a role in altering the history of the disease.
“Overall, diabetics did worse after surgery than non-diabetics, and it made no difference if those diabetic patients were taking metformin or other treatments—usually insulin,’ said Trushar Patel, MD, a Columbia University Medical Center, New York, New York, during the 2010 American Urological Association (AUA) Annual Meeting.
“Despite the biological evidence suggesting an antineoplastic activity with metformin in prostate cancer, it did not alter the natural history of prostate cancer in diabetics.”
Dr. Patel and colleagues examined outcomes among 210 diabetic patients, 112 of whom were being treated with metformin. The researchers matched those patients with 2 patients who did not have diabetes, enrolling 616 patients in the retrospective study.
The patients were aged about 62 years and had a mean preoperative prostate specific antigen score of 6.9 ng/mL. The estimated 5-year biochemical relapse-free rate was 75% for the control group that did not have diabetes; 66.1% for patients with diabetes on metformin; and 59.4% for patients with diabetes on non-metformin therapy.
Dr. Patel said that after adjusting the results for variables that included race, metformin use turned out not to be a significant factor in whether patients progressed.
“Diabetes—regardless of metformin use and race—was significantly associated with an increased likelihood of biochemical relapse rate after radical prostatectomy,” he said.
In the adjusted analyses, the likelihood of biochemical relapse was related to patients whose tumours had a Gleason score of at least 8 whose risk was 2.85-fold higher than those who did not progress (P
< .001); having a positive surgical margin, a 1.51-fold increased risk (P = .024); having a diagnosis of N1/N2 nodal disease which carried a 2.17-fold increased risk (P = .032); or having diabetes which carried a 1.55-fold greater risk of biochemical relapse (P = .034).
SOURCE: American Urological Association
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