title: Thiazolidinediones and metformin associated with improved survival of diabetic prostate cancer patients.
abstract: BACKGROUND
  The association between antidiabetic medications and the prognosis of human prostate cancer has not been explored. This study examined the impact of these drugs on the outcomes of diabetic patients with prostate cancer to provide a basis for diabetes management strategy in these patients.
  
  
  METHODS
  Records of consecutive prostate cancer patients with coexisting diabetes mellitus type 2 who were treated at the study institution between 15 July 1999 and 31 December 2008 were reviewed. The survival, cancer pathological grade, stage at the time of diagnosis, and antidiabetic pharmacotherapy of the patients were analyzed.
  
  
  RESULTS
  A total of 233 consecutive cases were analyzed. In Kaplan-Meier analysis, thiazolidinedione (log-rank, P = 0.005) and metformin (log-rank, P = 0.035) usage were significant predictors of improved overall survival, while insulin and insulin secretagogue usage were not significant predictors. Multivariate Cox regression analysis showed that thiazolidinedione {hazard ratio [HR] = 0.454 [95% confidence interval (CI) 0.213-0.965], P = 0.040} and metformin [HR = 0.550 (95% CI 0.315-0.960), P = 0.035] usage remained as significant predictors of favorable survival after controlling for variables including age, race, Gleason grade, and stage.
  
  
  CONCLUSIONS
  Thiazolidinediones and metformin appear to be associated with improved overall survival of diabetic prostate cancer patients. The choice of antidiabetic pharmacotherapy may influence overall survival of these patients.
authors.affiliation: Department of Molecular and Cellular Oncology; Emergency Medicine.
authors.forename: X-X
authors.initials: XX
authors.lastname: He
authors.affiliation: Genitourinary Medical Oncology.
authors.forename: S M
authors.initials: SM
authors.lastname: Tu
authors.affiliation: Department of Molecular and Cellular Oncology.
authors.forename: M-H
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Emergency Medicine; Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: syeung@mdanderson.org.
authors.forename: S-C J
authors.initials: SJ
authors.lastname: Yeung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D018709:Statistics, Nonparametric; D045162:Thiazolidinediones / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D008687:Metformin