Arima, R., Hautakoski, A., Marttila, M., Arffman, M., Sund, R., Ilanne-Parikka, P., Kangaskokko, J., Hinkula, M., Puistola, U., Läärä, E. (2017) Cause-specific mortality in endometrioid endometrial cancer patients with type 2 diabetes using metformin or other types of antidiabetic medication. Gynecologic Oncology, Volume 147, Issue 3, 2017, Pages 678-683, ISSN 0090-8258, https://doi.org/10.1016/j.ygyno.2017.10.014
Cause-specific mortality in endometrioid endometrial cancer patients with type 2 diabetes using metformin or other types of antidiabetic medication
|Author:||Arima, R.1; Hautakoski, A.2; Arffman, M.3;|
1Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, FIN-90029 Oulu, Finland
2Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, P.O. Box 310, FIN-90101 Oulu, Finland
3Service System Research Unit, National Institute for Health and Welfare, P.O. Box 30, FIN-00271 Helsinki, Finland
4Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland
5Institute of Clinical Medicine, University of Eastern Finland. P.O. Box 1627, FIN-70211 Kuopio, Finland
6Science Center, Tampere University Hospital, Tampere, Finland
7The Diabetes Center, Finnish Diabetes Association, FIN-33680 Tampere, Finland
8Department of Pathology, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 50, FIN-90029 Oulu, Finland
9Research Unit of Mathematical Sciences, University of Oulu, P.O. Box 8000, FIN-90014 Oulu, Finland
|Online Access:||PDF Full Text (PDF, 1.6 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019060418383
|Publish Date:|| 2019-06-04
Aim: To obtain further evidence of the association between metformin or other types of antidiabetic medication (ADM) and mortality from endometrial cancer (EC) and other causes of death in patients with endometrioid EC and type 2 diabetes (T2D).
Materials and methods: A retrospective cohort of women with existing T2D and diagnosed with endometrioid EC from 1998 to 2011, obtained from a nationwide diabetes database (FinDM), were included in the study. Cumulative mortality from EC and that from other causes was described by using the Aalen-Johansen estimator. Cause-specific mortality rates were analyzed by using Cox models, and adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) were estimated in relation to the use of different forms of ADM during the three-year period preceding EC diagnosis.
Results: From the FinDM cohort we identified 1215 women diagnosed with endometrioid EC, of whom 19% were metformin users, 12% were users of other types of oral antidiabetic medication, 25% used other types of oral antidiabetic medication plus metformin, 26% used insulin and 14% had no antidiabetic medication. Mortality from EC was not found to be different in women using metformin (HR 0.89, 95% Cl 0.52–1.54) but mortality from other causes was lower (HR 0.52, 95% Cl 0.31–0.88) compared with women using other types of oral ADM.
Conclusions: Our findings are inconclusive as to the possible effect of metformin on the prognosis of endometrioid EC in women with T2D. However, use of metformin may reduce mortality from other causes.
|Pages:||678 - 683|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3123 Gynaecology and paediatrics
112 Statistics and probability
This work was supported by grants from Jane and Aatos Erkko Foundation (T59127), the Finnish Cancer Foundation (T59129) and the Finnish Government Research Funds (K77729) admitted for University Hospital of Oulu. These instances had no role in the study design, the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the article for publication.
© 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.