title: The Effect of Metformin on Oncological Outcomes in Patients With Cervical Cancer With Type 2 Diabetes Mellitus.
abstract: The aim of this study was to evaluate any association between metformin use and oncological outcomes of cervical cancer in patients with type 2 diabetes mellitus (DM).
  
  
  
  We retrospectively identified 248 patients with cervical cancer with type 2 DM who received primary treatment between 2004 and 2015. The clinicopathological characteristics and oncological outcomes were collected and analyzed. The patients were then separated into metformin use (n = 118) or non-metformin use (n = 130) groups.
  
  
  
  With a median follow-up of 2.85 years, patients who were given metformin had lower recurrence rate than patients who did not receive metformin (P = 0.011). The 5-year disease-free survival (DFS) and overall survival (OS) were 81.55% and 93.27% in the metformin use group, and 65.06% and 86.82% for the non-metformin use group, respectively. In multivariate analysis, non-metformin use (hazard ratio [HR], 1.89; P = 0.037), baseline hypertension (HR, 2.52; P = 0.005), and stage (HR for stage II vs I, 3.48; HR for stage III vs I, 6.45; P = 0.01) were independent adverse prognostic factors for DFS, whereas the statistically significant independent prognostic factors for OS were age (HR for age >65 vs ≤50, 3.86; P = 0.044) and stage (HR for stage III-IVA vs I-II, 3.45; P = 0.007).
  
  
  
  Our findings demonstrate that metformin use is associated with improved DFS, but not in OS in patients with cervical cancer with type 2 DM. Further large-scale and long-term follow-up studies are warranted to confirm the antitumor effects of metformin.
authors.affiliation: *Department of Obstetrics and Gynecology, †Epidemiology Unit, and ‡Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Jitti
authors.initials: J
authors.lastname: Hanprasertpong
authors.forename: Ingporn
authors.initials: I
authors.lastname: Jiamset
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
authors.forename: Thanarpan
authors.initials: T
authors.lastname: Peerawong
authors.forename: Wikanda
authors.initials: W
authors.lastname: Hemman
authors.forename: Sasima
authors.initials: S
authors.lastname: Kornsilp
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin