title: Survival advantage observed with the use of metformin in patients with type II diabetes and colorectal cancer.
abstract: BACKGROUND
  Patients with type II diabetes mellitus (DM) have an increased risk of adenomatous colorectal (CRC) polyps and CRC cancer. The use of the anti-hyperglycemic agent metformin is associated with a reduced incidence of cancer-related deaths.
  
  
  METHODS
  We retrospectively evaluated the medical records of 4758 patients seen at a single institution and determined that 424 patients were identified by their physicians as having type II DM and CRC cancer. Data were subsequently acquired determining the subject's age, body mass index (BMI), and disease date of diagnosis, stage, site of cancer, treatment, and survival.
  
  
  RESULTS
  Patients with type II DM and CRC cancer treated with metformin as one of their diabetic medications had a survival of 76.9 months (95% CI=61.4-102.4) as compared with 56.9 months in those patients not treated with metformin (95% CI=44.8-68.8), P=0.048. By using a multivariable Cox regression model adjusted for age, sex, race, BMI, and initial stage of disease, we demonstrated that type II diabetic patients treated with metformin had a 30% improvement in overall survival (OS) when compared with diabetic patients treated with other diabetic agents.
  
  
  CONCLUSIONS
  Colorectal cancer patients with DM treated with metformin as part of their diabetic therapy appear to have a superior OS.
authors.affiliation: Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, TX 77030-4009, USA. cgarrett@mdanderson.org
authors.forename: C R
authors.initials: CR
authors.lastname: Garrett
authors.forename: H M
authors.initials: HM
authors.lastname: Hassabo
authors.forename: N A
authors.initials: NA
authors.lastname: Bhadkamkar
authors.forename: S
authors.initials: S
authors.lastname: Wen
authors.forename: V
authors.initials: V
authors.lastname: Baladandayuthapani
authors.forename: B K
authors.initials: BK
authors.lastname: Kee
authors.forename: C
authors.initials: C
authors.lastname: Eng
authors.forename: M M
authors.initials: MM
authors.lastname: Hassan
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D007004:Hypoglycemic Agents; D008687:Metformin