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Metformin does not affect risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database

Publication ,  Journal Article
Allott, EH; Abern, MR; Gerber, L; Keto, CJ; Aronson, WJ; Terris, MK; Kane, CJ; Amling, CL; Cooperberg, MR; Moorman, PG; Freedland, SJ
Published in: Prostate Cancer and Prostatic Diseases
December 1, 2013

Background:While epidemiologic studies suggest that metformin use among diabetics may decrease prostate cancer (PC) incidence, the effect of metformin use on PC outcome is unclear. We investigated the association between pre-operative metformin use, dose and duration of use and biochemical recurrence (BCR) in PC patients with diabetes who underwent radical prostatectomy (RP).Methods:We conducted a retrospective cohort analysis within the Shared Equal Access Regional Cancer Hospital (SEARCH) database of 371 PC patients with diabetes who underwent RP. Time to BCR between metformin users and non-users, and by metformin dose and duration of use was assessed using multivariable Cox proportional analysis adjusted for demographic, clinical and/or pathologic features. Time to castrate-resistant PC (CRPC), metastases and PC-specific mortality were explored as secondary outcomes using unadjusted analyses.Results:Of 371 diabetic men, 156 (42%) were using metformin before RP. Metformin use was associated with more recent year of surgery (P<0.0001) but no clinical or pathologic characteristics. After adjustment for year of surgery, clinical and pathologic features, there were no associations between metformin use (hazard ratio (HR) 0.93; 95% confidence interval (CI) 0.61-1.41), high metformin dose (HR 0.96; 95% CI 0.57-1.61) or duration of use (HR 1.00; 95% CI 0.99-1.02) and time to BCR. A total of 14 patients (3.8%) developed CRPC, 10 (2.7%) distant metastases and 8 (2.2%) died from PC. Unadjusted analysis suggested that high metformin dose vs non-use was associated with increased risk of CRPC (HR 5.1; 95% CI 1.6-16.5), metastases (HR 4.8; 95% CI 1.2-18.5) and PC-specific mortality (HR 5.0; 95% CI 1.1-22.5).Conclusions:Metformin use, dose or duration of use was not associated with BCR in this cohort of diabetic PC patients treated with RP. The suggestion that higher metformin dose was associated with increased risk of CRPC, metastases and PC-specific mortality merits testing in large prospective studies with longer follow-up. © 2013 Macmillan Publishers Limited All rights reserved.

Duke Scholars

Published In

Prostate Cancer and Prostatic Diseases

DOI

EISSN

1476-5608

ISSN

1365-7852

Publication Date

December 1, 2013

Volume

16

Issue

4

Start / End Page

391 / 397

Related Subject Headings

  • Urology & Nephrology
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Allott, E. H., Abern, M. R., Gerber, L., Keto, C. J., Aronson, W. J., Terris, M. K., … Freedland, S. J. (2013). Metformin does not affect risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database. Prostate Cancer and Prostatic Diseases, 16(4), 391–397. https://doi.org/10.1038/pcan.2013.48
Allott, E. H., M. R. Abern, L. Gerber, C. J. Keto, W. J. Aronson, M. K. Terris, C. J. Kane, et al. “Metformin does not affect risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database.” Prostate Cancer and Prostatic Diseases 16, no. 4 (December 1, 2013): 391–97. https://doi.org/10.1038/pcan.2013.48.
Allott EH, Abern MR, Gerber L, Keto CJ, Aronson WJ, Terris MK, et al. Metformin does not affect risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database. Prostate Cancer and Prostatic Diseases. 2013 Dec 1;16(4):391–7.
Allott, E. H., et al. “Metformin does not affect risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database.” Prostate Cancer and Prostatic Diseases, vol. 16, no. 4, Dec. 2013, pp. 391–97. Scopus, doi:10.1038/pcan.2013.48.
Allott EH, Abern MR, Gerber L, Keto CJ, Aronson WJ, Terris MK, Kane CJ, Amling CL, Cooperberg MR, Moorman PG, Freedland SJ. Metformin does not affect risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database. Prostate Cancer and Prostatic Diseases. 2013 Dec 1;16(4):391–397.

Published In

Prostate Cancer and Prostatic Diseases

DOI

EISSN

1476-5608

ISSN

1365-7852

Publication Date

December 1, 2013

Volume

16

Issue

4

Start / End Page

391 / 397

Related Subject Headings

  • Urology & Nephrology
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis