二甲双胍赋予肝切除后发生肝细胞癌复发的风险降低

StephenW

CANCER
Metformin confers risk reduction for developing hepatocellular carcinoma recurrence after liver resection
Authors

    First published: 13 November 2016Full publication history
    DOI: 10.1111/liv.13280View/save citation
    Cited by: 0 articles

    Article has an altmetric score of 2
    Funding Information

    [Correction added after online publication: November 23, 2016].

    Funding information

    This work was supported by grants from Chang Gung Medical Research Program (CORPG3E0151).
    Handling Editor: Luca Valenti
    Trial registration numberNot applicable.

Abstract
Background

Hepatocellular carcinoma recurrence following liver resection remains a great concern. The study aims to examine the chemopreventive effect of metformin in patients undergoing liver resection for hepatocellular carcinoma from a population-based study.
Methods

All patients registered as having hepatocellular carcinoma between January 1995 and December 2011 in a nationwide database were retrospectively analysed. Outcomes related to liver resection and the presence of diabetes mellitus were assessed. Prognosis in terms of the use of metformin was further explored, in which only patients in the long-term follow-up starting at 2 years were included for analysis.
Results

Patients with diabetes mellitus had a significantly poorer outcome than patients without diabetes mellitus. Among diabetes mellitus patients, metformin users had significantly better survival curves in both recurrence-free survival (P<.0001) and overall survival (P<.0001) after liver resection. The hazard ratio of metformin use in hepatocellular carcinoma patients with diabetes mellitus was 0.65 (P<.05, 95% CI=0.60-0.72) for hepatocellular carcinoma recurrence and 0.79 (P<.05, 95% CI=0.72-0.88) for overall survival after liver resection. The risk reduction in hepatocellular carcinoma recurrence after liver resection was significantly associated with a dose/duration dependent of accumulated metformin usage.
Conclusion

Diabetes mellitus has an adverse effect on patients with hepatocellular carcinoma regardless of treatment modality. The use of metformin significantly reduces the risk of hepatocellular carcinoma recurrence and improves the overall outcome of patients after liver resection if patients survives the initial 2 years. Nonetheless, a prospective controlled study is recommended for validating the metformin use on preventing postoperative hepatocellular carcinoma recurrence.

StephenW

癌症
二甲双胍赋予肝切除后发生肝细胞癌复发的风险降低
作者

    首次发布：2016年11月13日完整的出版历史
    DOI：10.1111 / liv.13280查看/保存引文
    引用：0文章

    文章的得分为2
    资金信息

    [在网上公布后补正：2​​016年11月23日]。

    资金信息

    这项工作得到了长春医学研究计划（CORPG3E0151）的资助。
    处理编辑：Luca Valenti
    试用注册号不适用。

抽象
背景

肝切除术后的肝细胞癌复发仍然是一个很大的问题。本研究旨在研究二甲双胍在肝细胞癌肝切除术患者中的化学预防效应。
方法

所有在1995年1月至2011年12月之间在全国数据库中注册为肝细胞癌的患者进行回顾性分析。评估与肝切除相关的结果和糖尿病的存在。进一步探讨了在二甲双胍使用方面的预后，其中仅包括开始于2年的长期随访中的患者用于分析。
结果

糖尿病患者的结局比没有糖尿病的患者明显更差。在糖尿病患者中，二甲双胍用户在肝切除后在无复发生存（P <0.0001）和总生存（P <0.0001）中具有显着更好的存活曲线。在肝细胞癌复发的肝细胞癌患者中二甲双胍使用的危险比为0.65（P <.05，95％CI = 0.60-0.72），在肝细胞癌复发的患者中为0.79（P <肝切除后的总生存率。肝切除后肝细胞癌复发的风险降低与依赖于累积的二甲双胍使用的剂量/持续时间显着相关。
结论

糖尿病对患有肝细胞癌的患者具有不利影响，而与治疗方式无关。如果患者在最初2年内存活，使用二甲双胍可显着降低肝细胞癌复发的风险，并改善肝切除术后患者的整体预后。尽管如此，一项前瞻性对照研究被推荐用于验证二甲双胍用于预防术后肝细胞癌复发。

MP4

老药新用
异曲同工

治疗慢性乙型肝炎的药物“丙帕锗”能遏制癌细胞转移
http://hbvhbv.info/forum/thread-1385025-1-1.html