Cargando…

Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study

Background: Type 2 Diabetes (DM2) and the consecutively daily use of antidiabetic medication are characterized by a frequent prevalence worldwide and were shown to impact the initiation and progression of malignant diseases. While these effects were observed in a variety of malignancies, comprehensi...

Descripción completa

Detalles Bibliográficos
Autores principales: Spoerl, Steffen, Gerken, Michael, Schimnitz, Susanne, Taxis, Juergen, Fischer, René, Lindner, Sophia R., Ettl, Tobias, Ludwig, Nils, Spoerl, Silvia, Reichert, Torsten E., Spanier, Gerrit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777346/
https://www.ncbi.nlm.nih.gov/pubmed/36547172
http://dx.doi.org/10.3390/curroncol29120758
_version_ 1784856080835149824
author Spoerl, Steffen
Gerken, Michael
Schimnitz, Susanne
Taxis, Juergen
Fischer, René
Lindner, Sophia R.
Ettl, Tobias
Ludwig, Nils
Spoerl, Silvia
Reichert, Torsten E.
Spanier, Gerrit
author_facet Spoerl, Steffen
Gerken, Michael
Schimnitz, Susanne
Taxis, Juergen
Fischer, René
Lindner, Sophia R.
Ettl, Tobias
Ludwig, Nils
Spoerl, Silvia
Reichert, Torsten E.
Spanier, Gerrit
author_sort Spoerl, Steffen
collection PubMed
description Background: Type 2 Diabetes (DM2) and the consecutively daily use of antidiabetic medication are characterized by a frequent prevalence worldwide and were shown to impact the initiation and progression of malignant diseases. While these effects were observed in a variety of malignancies, comprehensive data about the role of DM2 and antidiabetic drugs in the outcome of head and neck melanoma (HNM) patients are missing. Methods: This retrospective population-based cohort study included 382 HNM patients from Eastern Bavaria having received tumor resection to negative margins between 2010 and 2017. Recurrence-free survival (RFS) was evaluated with regard to DM2 and routine metformin intake. Statistical analysis was performed by uni- and multivariate analyses. The median follow-up time was 5.6 years. Results: DM2 was diagnosed in 68 patients (17.8%), routine metformin intake was found in 39 cases (10.2%). The univariate survival analysis revealed impaired 5-year RFS in HNM patients with DM2 compared to non-diabetic controls (p = 0.016; 64.0% and 74.5%, respectively). The multivariate Cox regression substantiated this effect (HR = 1.980, 95% CI = 1.108–3.538, p = 0.021). In detail, the cumulative locoregional recurrence rate displayed the most far-reaching negative effect on the RFS of diabetic HNM patients (HR = 4.173, 95% CI = 1.628–10.697, p = 0.003). For metformin intake, a profound positive effect on the RFS in multivariate statistics was observed, both in the complete cohort (HR = 0.396, 95% CI = 0.177–0.884, p = 0.024) as well as in the cohort of diabetic HNM patients (HR = 0.352, 95% CI = 0.135–0.913, p = 0.032). Conclusions: This study emphasizes that DM2 is a relevant comorbid condition in HNM patients, impairing patient survival. Metformin intake was associated with a favorable outcome in HNM patients, providing possible therapeutic implications for future adjuvant treatment regimes.
format Online
Article
Text
id pubmed-9777346
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-97773462022-12-23 Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study Spoerl, Steffen Gerken, Michael Schimnitz, Susanne Taxis, Juergen Fischer, René Lindner, Sophia R. Ettl, Tobias Ludwig, Nils Spoerl, Silvia Reichert, Torsten E. Spanier, Gerrit Curr Oncol Article Background: Type 2 Diabetes (DM2) and the consecutively daily use of antidiabetic medication are characterized by a frequent prevalence worldwide and were shown to impact the initiation and progression of malignant diseases. While these effects were observed in a variety of malignancies, comprehensive data about the role of DM2 and antidiabetic drugs in the outcome of head and neck melanoma (HNM) patients are missing. Methods: This retrospective population-based cohort study included 382 HNM patients from Eastern Bavaria having received tumor resection to negative margins between 2010 and 2017. Recurrence-free survival (RFS) was evaluated with regard to DM2 and routine metformin intake. Statistical analysis was performed by uni- and multivariate analyses. The median follow-up time was 5.6 years. Results: DM2 was diagnosed in 68 patients (17.8%), routine metformin intake was found in 39 cases (10.2%). The univariate survival analysis revealed impaired 5-year RFS in HNM patients with DM2 compared to non-diabetic controls (p = 0.016; 64.0% and 74.5%, respectively). The multivariate Cox regression substantiated this effect (HR = 1.980, 95% CI = 1.108–3.538, p = 0.021). In detail, the cumulative locoregional recurrence rate displayed the most far-reaching negative effect on the RFS of diabetic HNM patients (HR = 4.173, 95% CI = 1.628–10.697, p = 0.003). For metformin intake, a profound positive effect on the RFS in multivariate statistics was observed, both in the complete cohort (HR = 0.396, 95% CI = 0.177–0.884, p = 0.024) as well as in the cohort of diabetic HNM patients (HR = 0.352, 95% CI = 0.135–0.913, p = 0.032). Conclusions: This study emphasizes that DM2 is a relevant comorbid condition in HNM patients, impairing patient survival. Metformin intake was associated with a favorable outcome in HNM patients, providing possible therapeutic implications for future adjuvant treatment regimes. MDPI 2022-12-07 /pmc/articles/PMC9777346/ /pubmed/36547172 http://dx.doi.org/10.3390/curroncol29120758 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Spoerl, Steffen
Gerken, Michael
Schimnitz, Susanne
Taxis, Juergen
Fischer, René
Lindner, Sophia R.
Ettl, Tobias
Ludwig, Nils
Spoerl, Silvia
Reichert, Torsten E.
Spanier, Gerrit
Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study
title Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study
title_full Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study
title_fullStr Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study
title_full_unstemmed Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study
title_short Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study
title_sort prognostic relevance of type 2 diabetes and metformin treatment in head and neck melanoma: results from a population-based cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777346/
https://www.ncbi.nlm.nih.gov/pubmed/36547172
http://dx.doi.org/10.3390/curroncol29120758
work_keys_str_mv AT spoerlsteffen prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT gerkenmichael prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT schimnitzsusanne prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT taxisjuergen prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT fischerrene prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT lindnersophiar prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT ettltobias prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT ludwignils prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT spoerlsilvia prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT reicherttorstene prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy
AT spaniergerrit prognosticrelevanceoftype2diabetesandmetformintreatmentinheadandneckmelanomaresultsfromapopulationbasedcohortstudy