Abstract
Objective: Metformin has been associated with decreased cancer risk and mortality. However, the effects of metformin on clinical outcomes in oral cavity and oropharyngeal squamous cell carcinoma (OC/OP SCCA) have not been defined. We aimed to evaluate the association of metformin use and cancer recurrence in diabetic patients with OC/OP SCCA.
Method: We performed a retrospective review of all patients with diabetes mellitus type II treated at our tertiary medical center for OC/OP SCCA from 2001 to 2011. The patients’ demographics, cancer TNM stage, treatment, and outcomes were analyzed.
Results: We identified 69 patients with diabetes mellitus type 2 and OC/OP SCCA from 2001 to 2011. Twenty-three patients were taking metformin (11 early stage and 12 late stage) and 46 patients were not taking metformin (20 early stage and 26 late stage). Kaplan-Meier (KM) analysis and coproportional hazard univariate (Coph) analysis were performed. For early stage patients, the KM curve is promising, and the HR from the Comodel is 0.36 (P = .34), suggesting a substantial effect. There is less of an effect in late stage patients.
Conclusion: This is the first known clinical study evaluating the effect of metformin in head and neck cancer. Our results suggest metformin decreases recurrence for diabetic patients with early TNM stage OC/OP SCCA. Further study is needed to validate this benefit, as our limitation is likely related to sample size.
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