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The Effect of Metformin on Oncological Outcomes in Patients With Cervical Cancer With Type 2 Diabetes Mellitus
  1. Jitti Hanprasertpong, MD,
  2. Ingporn Jiamset, MD,
  3. Alan Geater, PhD,
  4. Thanarpan Peerawong, MD,
  5. Wikanda Hemman, MD and
  6. Sasima Kornsilp, MD
  1. * Department of Obstetrics and Gynecology,
  2. Epidemiology Unit, and
  3. Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
  1. Address correspondence and reprint requests to Jitti Hanprasertpong, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand. E-mail: hjitti{at}; hjitti{at}


Objective The aim of this study was to evaluate any association between metformin use and oncological outcomes of cervical cancer in patients with type 2 diabetes mellitus (DM).

Methods We retrospectively identified 248 patients with cervical cancer with type 2 DM who received primary treatment between 2004 and 2015. The clinicopathological characteristics and oncological outcomes were collected and analyzed. The patients were then separated into metformin use (n = 118) or non–metformin use (n = 130) groups.

Results With a median follow-up of 2.85 years, patients who were given metformin had lower recurrence rate than patients who did not receive metformin (P = 0.011). The 5-year disease-free survival (DFS) and overall survival (OS) were 81.55% and 93.27% in the metformin use group, and 65.06% and 86.82% for the non–metformin use group, respectively. In multivariate analysis, non–metformin use (hazard ratio [HR], 1.89; P = 0.037), baseline hypertension (HR, 2.52; P = 0.005), and stage (HR for stage II vs I, 3.48; HR for stage III vs I, 6.45; P = 0.01) were independent adverse prognostic factors for DFS, whereas the statistically significant independent prognostic factors for OS were age (HR for age >65 vs ≤50, 3.86; P = 0.044) and stage (HR for stage III-IVA vs I-II, 3.45; P = 0.007).

Conclusions Our findings demonstrate that metformin use is associated with improved DFS, but not in OS in patients with cervical cancer with type 2 DM. Further large-scale and long-term follow-up studies are warranted to confirm the antitumor effects of metformin.

  • Diabetes mellitus
  • Metformin
  • Prognosis
  • Uterine cervical neoplasms

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  • The authors declare no conflicts of interest.