Evidence map›Paper›PMID 30663219›Full record

ArticleLiver international : official journal of the International Association for the Study of the Liver2019

Treatment with metformin is associated with a prolonged survival in patients with hepatocellular carcinoma.

Lena Schulte, Bernhard Scheiner, Torsten Voigtländer, Sandra Koch, Nora Schweitzer, Silke Marhenke, Philipp Ivanyi, Michael P Manns, Thomas Rodt, Jan B Hinrichs and 4 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Liver international : official journal of the International Association for the Study of the Liver, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 6% 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

39 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.

  1. Pooled it
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  6. Effects of Biguanide-PROTACs in Pancreatic Cancer Cells.Molecules (Basel, Switzerland) · 2024
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  16. Role of metformin in the diagnosis, prevention, and treatment of hepatocellular carcinoma.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 2 countries.

Lena SchulteDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Bernhard ScheinerDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-4904-5133
Torsten VoigtländerDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Sandra KochDepartment of Internal Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Nora SchweitzerDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.ORCID 0000-0002-4687-3582
Silke MarhenkeDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Philipp IvanyiDepartment of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany.
Michael P MannsDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Thomas RodtHannover Medical School, Institute for Diagnostic and Interventional Radiology, Hannover, Germany.
Jan B HinrichsHannover Medical School, Institute for Diagnostic and Interventional Radiology, Hannover, Germany.
Arndt WeinmannDepartment of Internal Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Matthias PinterDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-7260-532X
Arndt VogelDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Martha M KirsteinDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.ORCID 0000-0001-9415-4083
Medizinische Hochschule Hannover · DEJohannes Gutenberg University Mainz · DEMedical University of Vienna · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatocellular carcinoma (HCC) is one of the most lethal cancers. Nutrition- and life style-associated risk factors are increasingly prevalent. Metformin, the mainstay of type 2 diabetes mellitus (T2DM)-treatment, reduces the risk of hepatocarcinogenesis. However, its influence on the prognosis of patients with HCC has not been investigated on a large scale, yet.

methodsFive thousand and ninety-three patients treated for HCC between 2000 and 2016 at three referral centres were included in this retrospective multicentre study. The aim of this study was to assess whether treatment with metformin for T2DM is associated with a prolonged overall survival (OS) in patients diagnosed with HCC.

resultsAmong 5093 patients with HCC, 1917 patients (37.6%) were diagnosed with T2DM, of which 338 (17.6%) received treatment with metformin. Compared to diabetic patients not treated with metformin, patients on metformin had a significantly better hepatic function (Child-Pugh-Score A: 69.2% vs 47.4%, P < 0.001) and underwent significantly more often tumour resection (22.1% vs 16.5%, P = 0.024). Patients on metformin had a significantly longer median OS (mOS) compared to diabetic patients not treated with metformin (22 vs 15 months, P = 0.019). The prolongation of survival was most significant in patients treated with surgery. Using a propensity score match (PSM), patients were adjusted for hepatic function and initial therapy. In the matched cohorts, mOS remained significantly longer in metformin-treated patients (22 vs 16 months, P = 0.021). Co-treatment of metformin and sorafenib was associated with a survival disadvantage.

conclusionTreatment with metformin was associated with an improved survival in patients with T2DM and HCC. This effect was most pronounced in patients at potentially curative tumour stages.

Indexed as

AgedAntineoplastic AgentsCarcinoma, HepatocellularDiabetes Mellitus, Type 2FemaleGermanyHumansHypoglycemic AgentsLiver NeoplasmsMaleMetforminMiddle AgedMultivariate AnalysisPrognosisPropensity ScoreRetrospective StudiesAntineoplastic AgentsHypoglycemic AgentsMetforminSorafenibdiabetesHCCmetforminNAFLD

Identifiers

PMID30663219
OpenAlexW2911918701

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.