Evidence map›Paper›PMID 25400459›Full record

ArticleWorld journal of gastroenterology2014

Metformin does not improve survival in patients with hepatocellular carcinoma.

Mamatha Bhat, Roongruedee Chaiteerakij, William S Harmsen, Cathy D Schleck, Ju Dong Yang, Nasra H Giama, Terry M Therneau, Gregory J Gores, Lewis R Roberts

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 33 citations in OpenAlex.

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  19. Non-alcoholic fatty liver disease and diabetes.Metabolism: clinical and experimental · 2016 · on this map
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Mamatha BhatMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Roongruedee ChaiteerakijMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
William S HarmsenMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Cathy D SchleckMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Ju Dong YangMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Nasra H GiamaMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Terry M TherneauMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Gregory J GoresMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Lewis R RobertsMamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States.
Mayo Clinic in Arizona · US

Funding

Women's Cancer ProgramP30CA015083 · NCI · MAYO CLINIC ROCHESTER · PI Felicity Enders · 1985 to 2026
$151.3M
Mayo Clinic Center for Translational Science ActivitiesUL1TR000135 · NCATS · MAYO CLINIC ROCHESTER · PI KHOSLA, SUNDEEP · 2012 to 2015
$41.2M
PILOT AND FEASIBILTY PROGRAMP30DK084567 · NIDDK · MAYO CLINIC ROCHESTER · PI GREGORY J. GORES · 2009 to 2026
$22.2M
Regulation of the Tumor Microenvironment in Hepatocellular CarcinomaR01CA165076 · NCI · MAYO CLINIC ROCHESTER · PI FERNANDEZ-ZAPICO, MARTIN ERNESTO, ROBERTS, LEWIS R · 2012 to 2016
$2.0M
NCATS NIH HHS UL1 TR000135NCI NIH HHS CA165076NCI NIH HHS N01 CA015083NCI NIH HHS P30 CA015083NCI NIH HHS R01 CA165076NIDDK NIH HHS P30 DK084567NIDDK NIH HHS P30DK084567
6 · The paper itself

Abstract

aimTo assess whether metformin, which has a chemopreventive effect in chronic liver disease, has any chemotherapeutic effect in hepatocellular carcinoma.

methodsThis was a retrospective study of 701 patients with newly diagnosed hepatocellular carcinoma (HCC) seen between January 2005 and June 2011 at Mayo Clinic, Rochester, Minnesota. This patient cohort was a part of the global HCC BRIDGE study, which is a large longitudinal study of HCC determining the real-world experience of HCC characteristics, management and patient outcomes. We defined significant metformin exposure as continuation of this agent at least 90 d beyond diagnosis of HCC, and compared survival of diabetic patients on metformin to diabetic patients not on metformin and non-diabetics.

resultsOur cohort was 72.9% male, with a mean ± SD age of 62.6 ± 12.3 years. The most common etiologies of liver disease were hepatitis C (34%), alcoholic liver disease (29%), fatty liver disease (15%) and hepatitis B (9%). By univariate analysis, using diabetics not on metformin as the reference group, diabetic patients with HCC on metformin had no survival advantage, with a HR (95%CI) of 1.0 (0.8-1.3). Non-diabetic HCC patients also did not appear to have a survival advantage as compared to diabetic HCC patients not on metformin, as demonstrated by a HR (95%CI) of 1.1 (0.7-1.7). Diabetics on metformin beyond 90 d after HCC diagnosis had a longer median survival at 34.2 mo, as compared to 25.5 mo among diabetic patients who were not on metformin or had discontinued metformin within 90 d after HCC diagnosis. This finding was likely due to potential survival bias among those who lived long enough to receive metformin.

conclusionAlthough the literature suggests a chemotherapeutic effect in other malignancies, our study demonstrates no survival benefit to the use of metformin in diabetic patients with HCC.

Indexed as

AdultAgedAged, 80 and overCarcinoma, HepatocellularDiabetes Mellitus, Type 2FemaleHumansHypoglycemic AgentsKaplan-Meier EstimateLiver NeoplasmsMaleMetforminMiddle AgedMinnesotaOdds RatioPrognosisHypoglycemic AgentsMetforminDiabetesHepatocellular carcinomaLactic acidosisLiver diseaseMetforminSurvival

Identifiers

PMID25400459
PMCPMC4229540
OpenAlexW2008108775

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.