Effect Of Metformin On Prognosis Of Epithelial Ovarian Cancer Patients Complicated With Type 2 Diabetes Mellitus

Background:Recently, studies have showed that the incidence of malignant neoplasms in type 2 diabetes mellitus (T2DM) patients was much higher than the normal cohort, such as breast, pancreatic, colorectal and ovarian cancer. Some clinical findings proposed T2DM as one of the risk factors for epithelial ovarian cancer (EOC), and T2DM might have an undesirable influence on the prognosis of epithelial ovarian cancer patients. Metformin is the first-line anti-diabetic agent. Some evidence showed that metformin have potential anti-ovarian cancer efficacy.Objective:This study was designed to explore the clinicopathological characteristics and prognostic factors of the ovarian cancer patients complicated with T2DM. What’s more, we explored the effect of metformin on prognosis of ovarian cancer patients complicated with T2DM. Hopefully this research would provide evidence for clinical application of metformin in antineoplasm therapy.Methods:The study enrolled 42 epithelial ovarian cancer patients complicated with T2DM and 99 randomly selected epithelial ovarian cancer patients without T2DM. Accroding to whether T2DM group patients have a regular intake of metformin, they were divided into two groups, metformin and non-metformin groups. The clinical information was retrospectively collected. Comparison was made between three groups as to the progression-free survival (PFS)and overall survival(OS). Survival curves were accomplish using the Kaplan-Meier method and were compared via log-rank test. P<0.05 was considered statistically significant. Cox multivariate analysis method was performed for PFS and OS analysis.Result:We observed a predominance of more elderly, advanced FIGO stage and high histological grade, more lymph node metastasis in the T2DM group. Compared with the other two groups, the non-metformin group showed unfavorable prognosis with shorter DFS and OS. The metformin group showed a similar prognosis to the control group. By Cox multivariate analysis, age, lymph node metastasis, histological grade, FIGO staging and intake of metformin could influence the PFS of epithelial ovarian cancer, and age, lymph node metastasis, histological grade, FIGO staging, complication with T2DM and intake of metformin could influence the OS.Conclusions:Complication with type 2 DM had a negative effect on OS of epithelial ovarian cancer patients. Intake of metformin can improve long-term survival and reduce the risk of relapse and metastasis of epithelial ovarian cancer patients complicated With T2DM.