Importance: Despite the existing guideline’s recommendation of metformin therapy as the initial approach for managing diabetes mellitus (DM), there remains a scarcity of comprehensive documentation regarding metformin’s impact on outcomes that are important for patients. Objectives: The objective of this study was to assess the potential impact of metformin treatment on the risk of death in individuals diagnosed with both gastric cancer and pre-existing diabetes mellitus (DM); Design, Setting, and Participants: The study made use of a dataset encompassing nationwide health insurance claims, allowing for a retrospective analysis of all patients with a history of gastric cancer diagnosis (classified under International Classification of Diseases 10th Revision code: C16.X) spanning from 1 January 2002 to 31 December 2012. The primary objective was to observe death within a 5-year follow-up period. The study population comprised 63,664 individuals who fell into two categories: those treated with metformin (n = 29,548) and those who did not receive metformin treatment (n = 34,116). This classification was based on the initial treatment allocation following the diagnosis of gastric cancer. Exposures: Metformin treatment, comorbidities, concurrent medication, and procedural information. Outcomes: All-cause death, disease-specific death, cardiovascular death. Results: During the 5-year follow-up period, the metformin treatment group exhibited a lower cumulative incidence of all-cause death (27.5%) in comparison to the group not receiving metformin treatment (32.8%). Furthermore, the relative hazards for all-cause death were significantly reduced in the metformin treatment group (HR: 0.80, 95% CI 0.78–0.82), indicating a lower risk of death when compared to the non-metformin group. In addition, metformin treatment was associated with lower occurrences of disease-specific death (related to gastric cancer) and cardiovascular death when compared to the group not undergoing metformin treatment. Conclusions: The findings demonstrated that the use of metformin was effective at improving prognosis among gastric cancer patients documented with prior DM. In this population-based cohort study, metformin treatment was associated with reduced risk of mortality.
重要性：尽管现行指南推荐二甲双胍作为糖尿病管理的初始治疗方案，但关于二甲双胍对患者重要结局影响的全面记录仍显不足。目的：本研究旨在评估二甲双胍治疗对同时患有胃癌与糖尿病的患者死亡风险的潜在影响。研究设计、场所与参与者：本研究利用全国健康保险理赔数据库，对2002年1月1日至2012年12月31日期间所有胃癌确诊患者（国际疾病分类第十版编码：C16.X）进行回顾性分析，主要观察终点为5年随访期内的死亡情况。研究人群共63,664例，根据胃癌确诊后的初始治疗方案分为二甲双胍治疗组（n=29,548）与非二甲双胍治疗组（n=34,116）。暴露因素：二甲双胍治疗、合并症、联合用药及手术信息。结局指标：全因死亡、疾病特异性死亡（胃癌相关死亡）、心血管死亡。结果：在5年随访期间，二甲双胍治疗组的全因死亡累积发生率（27.5%）低于非二甲双胍治疗组（32.8%）。二甲双胍治疗组的全因死亡风险显著降低（风险比：0.80，95%置信区间0.78-0.82）。此外，与非二甲双胍治疗组相比，二甲双胍治疗组的疾病特异性死亡（胃癌相关死亡）和心血管死亡发生率也更低。结论：本研究表明，二甲双胍能有效改善既往有糖尿病病史的胃癌患者的预后。在这项基于人群的队列研究中，二甲双胍治疗与死亡风险降低相关。
肿瘤(癌症)患者之家