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

Autor: Spoerl S; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Gerken M; Tumor Center-Institute for Quality Management and Health Services Research, University of Regensburg, 93053 Regensburg, Germany., Schimnitz S; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Taxis J; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Fischer R; Department of Otorhinolaryngology, University Hospital Regensburg, 93053 Regensburg, Germany., Lindner SR; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Ettl T; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Ludwig N; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Spoerl S; Department of Internal Medicine 5-Hematology/Oncology, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany., Reichert TE; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Spanier G; Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany.
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2022 Dec 07; Vol. 29 (12), pp. 9660-9670. Date of Electronic Publication: 2022 Dec 07.
DOI: 10.3390/curroncol29120758
Abstrakt: 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.
Databáze: MEDLINE
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