Evidence mapPaperPMID 39757744Full record

ArticleCancer medicine2025

Repurposing of Metformin to Improve Survival Outcomes in Patients With Upper Tract Urothelial Carcinoma.

Hsiang Ying Lee, Po-Hung Lin, See-Tong Pang, Jen-Kai Fang, Chung-You Tsai, Yao-Chou Tsai, Yung-Tai Chen, Wei-Chieh Chen, Hsin-Chih Yeh, Wei-Ming Li

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Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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10 authors.

Hsiang Ying LeeDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.ORCID https://orcid.org/0000-0003-2405-4874
Po-Hung LinDivision of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.
See-Tong PangDivision of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.
Jen-Kai FangDivision of Urology, China Medical University Hospital, Taichung, Taiwan.
Chung-You TsaiDepartment of Urology, Far Eastern Memorial Hospital, Taiwan.
Yao-Chou TsaiDivision of Urology, Taipei Tzu Chi Hospital, Taiwan Urological Association Collaborative Research Organization, Taipei, Taiwan.
Yung-Tai ChenDepartment of Urology, Taiwan Adventist Hospital, Taipei, Taiwan.
Wei-Chieh ChenDepartment of Urology, Taipei Medical University, Taipei, Taiwan.
Hsin-Chih YehDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.ORCID https://orcid.org/0000-0003-4113-629X
Wei-Ming LiDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUpper tract urothelial carcinoma (UTUC) presents a higher incidence rate in Taiwan compared to Western societies. The aim of this study is to investigate the potential of metformin in improving survival outcomes for patients with UTUC in Taiwan. MATERIAL AND

methodsThis retrospective study included 940 patients with UTUC and type 2 diabetes from the Taiwan UTUC Collaboration Group, spanning 21 hospitals from July 1988 to September 2023. Patients were divided into two groups: those treated with metformin (n = 215) and those without metformin treatment (n = 725). Parameters analyzed included age, BMI, renal function, tumor grade and location, and pathological staging. Oncological outcomes measured were overall survival (OS), cancer-specific survival (CSS), and bladder recurrence-free survival (BRFS). Statistical analysis involved the use of Student's t-test, Mann-Whitney test, Chi-squared test, Fisher's exact test, and Cox proportional hazard regression.

resultsSignificant differences were observed between the two groups in BMI, preoperative creatinine, eGFR, tumor location, tumor laterality, tumor size, and pathological grade and T stage. Patients treated with metformin exhibited a lower risk of CSS (HR = 0.619; p = 0.018) and improved OS (HR = 0.713; p = 0.024), although no significant association was found with BRFS (HR = 1.034; p = 0.791). The protective effect of metformin on OS was particularly significant in patients with advanced T stage, metastasis, and high-grade tumors.

conclusionThe study suggests that metformin use in UTUC patients with diabetes is associated with improved OS and CSS but not BRFS. The underlying mechanisms warrant further investigation. Repurposing metformin, a well-established and safe drug, may develop new therapeutic strategies for UTUC.

Indexed as

Diabetes Mellitus, Type 2Drug RepositioningMetforminAgedAged, 80 and overCarcinoma, Transitional CellFemaleHumansHypoglycemic AgentsMaleMiddle AgedRetrospective StudiesTaiwanUreteral NeoplasmsUrologic NeoplasmsHypoglycemic AgentsMetforminmetforminSurvival outcomeupper tract urothelial carcinoma

Identifiers

PMID39757744
PMCPMC11702374

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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 Socratic graph.