PMID- 38246042
OWN - NLM
STAT- MEDLINE
DCOM- 20240325
LR  - 20240325
IS  - 1095-6859 (Electronic)
IS  - 0090-8258 (Linking)
VI  - 182
DP  - 2024 Mar
TI  - Associations of metformin therapy treatment with endometrial cancer risk and 
      prognosis: A systematic review and meta-analysis.
PG  - 15-23
LID - S0090-8258(24)00007-6 [pii]
LID - 10.1016/j.ygyno.2024.01.007 [doi]
AB  - BACKGROUND: Several abstract studies have demonstrated that metformin may be 
      beneficial for preventing and treating endometrial cancer (EC), while the results 
      have been inconsistent and inconclusive. This systematic review and meta-analysis 
      aimed to investigate the association between metformin use and the incidence and 
      mortality of endometrial cancer in diabetic patients. METHODS: A systematic 
      literature search was performed in Pubmed, EMBASE, Web of Science, Cochrane 
      Library, SinoMed, CNKI, Wanfang Data, and VIP from inception to November 2022. 
      The outcome measures were hazard ratios (HRs) comparing the EC incidence and 
      mortality in patients with type 2 diabetes mellitus (T2DM) on metformin and 
      non-metformin. A random or fixed-effects model was applied for data analysis, and 
      subgroup analysis was performed to look for factors of heterogeneity. The Grading 
      of Recommendations Assessment, Development, and Evaluation (GRADE) assessed the 
      evidence's certainty. RESULTS: Eleven studies reported data on EC incidence. The 
      pooled results suggested that the use of metformin was associated with a 
      significantly higher incidence of EC (HR = 1.17, 95% CI 1.09-1.26, P < 0.0001). 
      Further, seventeen studies were included for survival analysis. The pooled data 
      showed that metformin could significantly decrease all-cause mortality 
      (HR = 0.62, 95% CI 0.52-0.74, P < 0.00001) and endometrial cancer-specific 
      mortality (HR = 0.95, 95% CI 0.90, 1.00, P = 0.03). Finally, we noted that 
      metformin was associated with significantly improving the progression-free 
      survival (PFS) of EC patients with T2DM (HR = 0.55, 95% CI 0.44, 0.68, 
      P < 0.00001). CONCLUSIONS: This meta-analysis did not prove that metformin was 
      beneficial for preventing EC. However, metformin could reduce their mortality 
      risk and prolong the progression-free survival time of EC patients with T2DM.
CI  - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Xie, Hui
AU  - Xie H
AD  - The First Clinical Medical College of Henan University of Chinese Medicine, 
      Zhengzhou 450000, China.
FAU - Li, Muhan
AU  - Li M
AD  - The First Clinical Medical College of Nanjing University of Chinese Medicine, 
      Nanjing 210023, China.
FAU - Zheng, Yuling
AU  - Zheng Y
AD  - The First Clinical Medical College of Henan University of Chinese Medicine, 
      Zhengzhou 450000, China. Electronic address: zhengyl@hactcm.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20240120
PL  - United States
TA  - Gynecol Oncol
JT  - Gynecologic oncology
JID - 0365304
RN  - 9100L32L2N (Metformin)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Female
MH  - Humans
MH  - *Metformin/therapeutic use
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology
MH  - Hypoglycemic Agents/therapeutic use
MH  - *Endometrial Neoplasms/drug therapy/epidemiology/complications
MH  - Risk
MH  - Prognosis
OTO - NOTNLM
OT  - Endometrial cancer
OT  - Incidence
OT  - Meta-analysis
OT  - Metformin
OT  - Mortality
COIS- Declaration of competing interest No potential conflicts of interest were 
      disclosed.
EDAT- 2024/01/22 00:42
MHDA- 2024/03/25 06:42
CRDT- 2024/01/21 18:07
PHST- 2023/07/06 00:00 [received]
PHST- 2023/12/29 00:00 [revised]
PHST- 2024/01/06 00:00 [accepted]
PHST- 2024/03/25 06:42 [medline]
PHST- 2024/01/22 00:42 [pubmed]
PHST- 2024/01/21 18:07 [entrez]
AID - S0090-8258(24)00007-6 [pii]
AID - 10.1016/j.ygyno.2024.01.007 [doi]
PST - ppublish
SO  - Gynecol Oncol. 2024 Mar;182:15-23. doi: 10.1016/j.ygyno.2024.01.007. Epub 2024 
      Jan 20.