Document Detail


Clinical outcomes after radical prostatectomy in diabetic patients treated with metformin.
MedLine Citation:
PMID:  20627287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate the relationship between diabetes and metformin use with outcomes after radical prostatectomy (RP) for clinically localized cancer.
METHODS: A total of 112 diabetic metformin users and 98 diabetic non-metformin users treated with RP from 1990 to 2009 were identified. Nondiabetic controls were match using their 5-year risk of biochemical recurrence (BCR) as calculated by the preoperative Kattan nomogram.
RESULTS: A total of 616 patients were evaluated in this study. There was no significant difference between nondiabetic and diabetic patients, including metformin users, with respect to age, clinical stage, preoperative prostate-specific antigen (PSA) score, pathologic Gleason score, and pathologic stage. Diabetic patients, including metformin users, were more likely to be of African American or Hispanic background than were nondiabetic controls (P = .001). The estimated 5-year BCR-free survival was 75.0% for nondiabetic patients, compared with 66.1% for metformin users and 59.3% for diabetic non-metformin users (P = .004). In multivariate analysis, metformin use was not significantly associated with risk of BCR (HR = 0.94; 95% CI = 0.6-1.5, P = .817). However, being diabetic, regardless of metformin use, resulted in a 55% increase in risk of BCR (HR = 1.55; 95% CI = 1.03-2.33, P = .034).
CONCLUSIONS: Diabetes, regardless of metformin use, was significantly associated with an increased likelihood of BCR after RP. Metformin use did not prove to be of any benefit. These observations underscore the importance for further studies evaluating the metabolic pathways that affect prostate cancer biology.
Authors:
Trushar Patel; Greg Hruby; Ketan Badani; Cory Abate-Shen; James M McKiernan
Related Documents :
8075887 - Importance of the intestine as a site of metformin-stimulated glucose utilization.
11460577 - Oral hypoglycemic agents: insulin secretagogues, alpha-glucosidase inhibitors and insul...
19317897 - Diabetic cardiomyopathy: effects of fenofibrate and metformin in an experimental model-...
16595597 - The e23k variant of kcnj11 encoding the pancreatic beta-cell adenosine 5'-triphosphate-...
9032097 - Effects of multiple daily insulin injections and intraperitoneal insulin therapy on cho...
18075857 - Insulin administration confers diabetes-preventive properties to nod mice derived dendr...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology     Volume:  76     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1240-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York 10032, USA. tp2200@columbia.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Antineoplastic Agents / therapeutic use
Diabetes Mellitus, Type 2 / complications,  drug therapy*
Disease-Free Survival
Humans
Hypoglycemic Agents / therapeutic use*
Male
Metformin / therapeutic use*
Middle Aged
Prostate-Specific Antigen / blood
Prostatectomy*
Prostatic Neoplasms / blood,  complications,  surgery*
Recurrence
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Hypoglycemic Agents; 657-24-9/Metformin; EC 3.4.21.77/Prostate-Specific Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  (Almost) painless surgery: a historical review of the evolution of intraurethral anesthesia in urolo...
Next Document:  Consequences of Peritoneal Tears During Hand-assisted Retroperitoneoscopic Nephroureterectomy.