The effect of metformin therapy on incidence and prognosis in prostate cancer: A systematic review and meta-analysis

The relationship between metformin and prostate cancer (PCa) remains controversial. To clarify this association, the PubMed, Embase and Cochrane library databases were systematically searched from their inception dates to May 23, 2018, using the keywords “metformin” and “prostate cancer” to identify...

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Bibliographic Details
Published in:Scientific reports 2019-02, Vol.9 (1), p.2218, Article 2218
Main Authors: He, Kancheng, Hu, Huating, Ye, Senlin, Wang, Haohui, Cui, Rongrong, Yi, Lu
Format: Article
Language:English
Subjects:
692/4025/1752
692/499
Antidiabetics
Disease Susceptibility
Humanities and Social Sciences
Humans
Hypoglycemic Agents - adverse effects
Hypoglycemic Agents - therapeutic use
Incidence
Male
Medical prognosis
Meta-analysis
Metformin
Metformin - adverse effects
Metformin - therapeutic use
multidisciplinary
Patients
Prognosis
Proportional Hazards Models
Prostate cancer
Prostatic Neoplasms - epidemiology
Prostatic Neoplasms - etiology
Prostatic Neoplasms - mortality
Science
Science (multidisciplinary)
Survival
Survival Analysis
Systematic review
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Summary:The relationship between metformin and prostate cancer (PCa) remains controversial. To clarify this association, the PubMed, Embase and Cochrane library databases were systematically searched from their inception dates to May 23, 2018, using the keywords “metformin” and “prostate cancer” to identify the related studies. The results included incidence, overall survival (OS), PCa-specific survival (CSS) and recurrence-free survival (RFS), which were measured as hazard ratios (HR) with a 95% confidence interval (95% CI) using Review Manager 5.3 software. A total of 30 cohort studies, including 1,660,795 patients were included in this study. Our study revealed that metformin treatment improves OS, CSS and RFS in PCa (HR = 0.72, 95% CI: 0.59–0.88, P = 0.001; HR = 0.78, 95% CI: 0.64–0.94, P = 0.009; and HR = 0.60, 95% CI: 0.42–0.87 P = 0.006, respectively) compared with non-metformin treatment. However, metformin usage did not reduce the incidence of PCa (HR = 0.86, 95% CI: 0.55–1.34, P = 0.51). In conclusion, compared with non-metformin treatment, metformin therapy can significantly improve OS, CSS and RFS in PCa patients. No association was noted between metformin therapy and PCa incidence. This study indicates a useful direction for the clinical treatment of PCa.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-018-38285-w