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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: Gum-chewing,gynecological cancer surgery,gastrointestinal function recovery,postoperative bowel ileus
- چکیده:
- چکیده انگلیسی: Objective: To evaluate the efficacy of postoperative gum-chewing compare with routine postoperative care on the recovery of gastrointestinal function after comprehensive surgical staging for gynecological cancer. Materials and methods: A total of 82 patients who underwent comprehensive surgical staging for gynecological cancer at Rajavithi Hospital between October 1st, 2018 and June 30th, 2019 were randomly allocated into two groups: Gum-chewing group (n=40) and control group (n=42). In the gum-chewing group, patients were assigned to chew sugar-free gum for 30 minutes starting from the first postoperative morning then every 8 hours until the first passage of flatus. In the control group, patients have received routine postoperative care. The primary endpoint was time to first flatus after surgery. The secondary endpoints were time to first bowel sound, time to first defecation, time to first walk, postoperative analgesia and anti-emetic drug requirement, ileus symptoms, length of a hospital stay, and potential adverse events of gum-chewing, including dry mount, choking, and aspiration. Result: Chewing gum was statistically significant in reducing time to first flatus compared with routine postoperative care (median 24.7 (range 2.2-86.5) vs 35.4 (range 7.2-80.9) hours, p=0.025). The length of a hospital stay was also significantly shorter in the gum-chewing group (median 3.0 (range 1.0-8.8) vs 3.5 (range 1.8-50.0) days, p=0.023). There were no significant differences in time to first bowel sound, time to first defecation, time to first walk, postoperative analgesia and anti-emetic drug requirement, and ileus symptoms between both two groups. No adverse events related to postoperative gum-chewing were observed. Conclusion: Gum-chewing was associated with early recovery of gastrointestinal function in patients undergoing surgery for gynecological cancer. It is an inexpensive and physiologic intervention that appears to be reasonably safe and should be recommended as an adjunct in postoperative care of gynecological cancer surgery.
- انتشار مقاله: 06-09-1398
- نویسندگان: Arphamart Nanthiphatthanachai,Putsarat Insin
- 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