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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Endometrial cancer,Metformin,Ki-67 index,Proliferative marker
- چکیده:
- چکیده انگلیسی: Objective: To compare the Ki-67 index of endometrial cancer cells before and after treatment between the metformin and placebo group in women with endometrial cancer (EC). Methods: This study was a randomized, double-blind, placebo-controlled trial conducting in non-diabetic women who diagnosed with endometrioid EC and had a schedule for elective surgical staging at Rajavithi Hospital between August 2018 and June 2019. Tissue specimens were obtained via endometrial curettage at the time of initial diagnosis (pre-treatment) and hysterectomy (post-treatment) to assess the value of the Ki-67 index by immunochemistry. Patients were randomly assigned into 2 groups: metformin and placebo group. Metformin 850 mg or placebo 1 tab were administered once daily for at least 7 days, starting on the first morning after recruitment until one day before surgery. Baseline characteristics (e.g., age, body mass index, co-morbidities) including surgical and pathological characteristics were recorded. The metabolic effect of metformin was also evaluated by a recording of fasting blood sugar, HbA1C and potential adverse events including nausea, vomiting, dizziness, and hypoglycemic symptom. Results: A total of 49 EC patients were included in this study. Twenty-five patients were assigned to the metformin group and 24 patients were assigned to the placebo group. Baseline demographic, surgical, and pathological characteristics between the 2 groups were similar. Metformin significantly changed the Ki-67 index relative to placebo, with a mean decrease of 23.3% (p=0.001) and a mean proportional decrease of 39.1% (p=0.006) before and after treatment. Additionally, no significant differences were detected in metabolic effects and adverse events between the metformin and the placebo groups. Conclusion: Short-term treatment with an oral metformin significantly reduced a proliferative marker Ki-67 index in women with endometrioid EC awaiting surgical staging. This study supports the biological effect of metformin in EC and potential applications in the adjuvant treatment in EC patients.
- انتشار مقاله: 24-08-1398
- نویسندگان: Kittisak Petchsila,Nisa Prueksaritanond,Putsarat Insin,Marut Yanaranop,Nutpacha Chotikawichean
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: diabetes,Overall Survival,Endometrial cancer,Metformin,Progression-free survival
- چکیده:
- چکیده انگلیسی: Objectives: To compare survival outcomes between endometrial cancer (EC) patients with diabetes who used
metformin to those who did not use metformin. Materials and Methods: A retrospective cohort study was conducted
of EC patients who were diabetes at the time of their cancer diagnosis and had been scheduled for elective surgery
at Rajavithi Hospital between 1 January 2003 and 31 December 2013. The patients were excluded if they had type
I diabetes mellitus and a history of other cancers. Results: Of 1,262 EC patients in the study period, there was 212
(16.8%) patients who met the inclusion criteria. Among them, 90 (42.5%) were non-metformin users and 122 (57.5%)
were metformin users. With a median follow-up of 47 months, the 5-year overall survivals (76.4% vs 77.9%, p=0.959)
and the 5-year progression-free survivals (92.6% vs 84.7%, p=0.091) did not significantly differ between the both
groups. On Cox proportional-hazards regression analysis, independent prognostic factors for overall survival (OS)
were FIGO stage, depth of myometrial invasion, and cervical involvement. Patients with non-endometrioid histology
and advanced stage were found to have a significant effect on progression-free survival (PFS). However, metformin
used did not predict either OS (HR, 0.99; 95%CI, 0.56-1.73; p=0.959) or PFS (HR, 2.19; 95%CI, 0.86-5.55; p=0.099).
Conclusion: Overall, a significant effect of metformin on survival outcomes in EC patients with diabetes was not found
in the current study. Larger studies with a prospective randomized control design are needed to clarify the benefit of
metformin as a strategy for endometrial cancer prevention and treatment.- انتشار مقاله: 05-08-1396
- نویسندگان: Putsarat Insin,Nisa Prueksaritanond
- مشاهده