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Sci Rep. 2019 Feb 18;9(1):2218. doi: 10.1038/s41598-018-38285-w.

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

Author information

1
Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
2
The First Hospital of Hunan University of Chinese Medicine, Changsha, 410007, China.
3
Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, 410011, China. rongrongcui@csu.edu.cn.
4
Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, 410011, China. yilu9999@csu.edu.cn.

Abstract

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.

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