PMID- 37664473
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230905
IS  - 1948-9358 (Print)
IS  - 1948-9358 (Electronic)
IS  - 1948-9358 (Linking)
VI  - 14
IP  - 8
DP  - 2023 Aug 15
TI  - Prognostic role of metformin in diabetes mellitus type 2 patients with 
      hepatocellular carcinoma: A systematic review and meta-analysis.
PG  - 1289-1300
LID - 10.4239/wjd.v14.i8.1289 [doi]
AB  - BACKGROUND: Hepatocellular carcinoma (HCC) is among the commonest malignancies 
      associated with significant cancer-related death. The identification of 
      chemo-preventive agents following HCC treatments with the potential to lower the 
      risk of HCC adverse course is intriguing. Metformin, a first-line agent used in 
      the treatment of type 2 diabetes mellitus (T2DM), has been associated with 
      inhibition of HCC growth. AIM: To determine whether metformin can prevent adverse 
      events (i.e., death, tumor progression, and recurrence) after any HCC treatment 
      in T2DM patients. METHODS: A systematic review of the published literature was 
      undertaken focused on the role of metformin on outcomes in patients with T2DM and 
      HCC receiving any tumor therapy. A search of the PubMed and Cochrane Central 
      Register of Con-trolled Trials Databases was conducted. RESULTS: A total of 13 
      studies (n = 14886 patients) were included in this review. With regard to the 
      risk of death, a decreased risk was reported in cases receiving metformin, 
      although this decrease was not statistically significant [odds ratio (OR) = 0.89, 
      P = 0.42]. When only patients treated with curative strategies were considered, a 
      more marked correlation between metformin and favorable cases was reported (OR = 
      0.70, P = 0.068). When analyzing palliative treatment, there was no statistical 
      significance in terms of the correlation between metformin and favorable cases 
      (OR = 0.74, P = 0.66). As for the risks of progressive disease and recurrence, no 
      obvious correlation between metformin use and reduced risk was reported. When 
      sub-analyses were performed for patients from different regions, the results for 
      patients from Eastern countries showed a tendency for decreased risk of death in 
      T2DM cases receiving metformin (OR = 0.69, P = 0.17), but the same was not seen 
      in patients from Western countries (OR = 1.19, P = 0.31). CONCLUSION: Metformin 
      failed to show a marked impact in preventing adverse effects after HCC treatment. 
      A trend was reported in T2DM cases receiving curative therapies in relation to 
      the risk of death, especially in patients from Eastern regions. Great 
      heterogeneity was reported among the different studies. Further large studies are 
      required to definitively clarify the real impact of metformin as a 
      chemopreventive agent for HCC.
CI  - (c)The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Cigrovski Berkovic, Maja
AU  - Cigrovski Berkovic M
AD  - Department of Kinesiological Anthropology and Methodology, Faculty of 
      Kinesiology, University of Zagreb, Zagreb 10000, Croatia. 
      maja.cigrovskiberkovic@gmail.com.
FAU - Giovanardi, Francesco
AU  - Giovanardi F
AD  - General Surgery and Organ Transplantation Unit, Department of Surgery, Sapienza 
      University of Rome, Rome 00018, Italy.
FAU - Mrzljak, Anna
AU  - Mrzljak A
AD  - Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, 
      Zagreb 10000, Croatia.
AD  - Department of Medicine, School of Medicine, Zagreb 10000, Croatia.
FAU - Lai, Quirino
AU  - Lai Q
AD  - General Surgery and Organ Transplantation Unit, Department of Surgery, Sapienza 
      University of Rome, Rome 00018, Italy.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Diabetes
JT  - World journal of diabetes
JID - 101547524
PMC - PMC10473950
OTO - NOTNLM
OT  - Death
OT  - Hepatocellular carcinoma
OT  - Metformin
OT  - Progression
OT  - Recurrence
OT  - Treatment
OT  - Type 2 diabetes mellitus
COIS- Conflict-of-interest statement: All the authors report no relevant conflicts of 
      interest for this article.
EDAT- 2023/09/04 06:42
MHDA- 2023/09/04 06:43
PMCR- 2023/08/15
CRDT- 2023/09/04 05:14
PHST- 2023/02/27 00:00 [received]
PHST- 2023/04/24 00:00 [revised]
PHST- 2023/05/16 00:00 [accepted]
PHST- 2023/09/04 06:43 [medline]
PHST- 2023/09/04 06:42 [pubmed]
PHST- 2023/09/04 05:14 [entrez]
PHST- 2023/08/15 00:00 [pmc-release]
AID - 10.4239/wjd.v14.i8.1289 [doi]
PST - ppublish
SO  - World J Diabetes. 2023 Aug 15;14(8):1289-1300. doi: 10.4239/wjd.v14.i8.1289.