Retrospective Study
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World J Gastroenterol. Nov 14, 2014; 20(42): 15750-15755
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15750
Metformin does not improve survival in patients with hepatocellular carcinoma
Mamatha Bhat, Roongruedee Chaiteerakij, William S Harmsen, Cathy D Schleck, Ju Dong Yang, Nasra H Giama, Terry M Therneau, Gregory J Gores, Lewis R Roberts
Mamatha Bhat, Roongruedee Chaiteerakij, Ju Dong Yang, Nasra H Giama, Gregory J Gores, Lewis R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States
Mamatha Bhat, Division of Gastroenterology, McGill University Health Centre, Montréal, QC H3G 2M1, Canada
Roongruedee Chaiteerakij, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
William S Harmsen, Cathy D Schleck, Terry M Therneau, Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN 55902, United States
Author contributions: Bhat M and Chaiteerakij R contributed equally to the manuscript; Bhat M, Chaiteerakij R, Harmsen WS, Therneau TM, Gores GJ and Roberts LR designed the study; Bhat M, Chaiteerakij R, Yang JD and Giama NH acquired the data; Harmsen WS, Schleck CD and Therneau TM analyzed and interpreted the data; Bhat M and Chaiteerakij R drafted the manuscript; Roberts LR, Gores GJ, Therneau TM, Schleck CD and Harmsen WS critically reviewed and edited the manuscript.
Supported by National Institutes of Health, No. NCI CA165076; Mayo Clinic Center for Cell Signaling in Gastroenterology, No. NIDDK P30DK084567; Mayo Clinic Cancer Center, No. NCI CA15083; and Mayo Clinic Center for Clinical and Translational Science, No. NCATS UL1 TR000135
Correspondence to: Lewis R Roberts, MBChB, PhD, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, United States. roberts.lewis@mayo.edu
Telephone: +1-507-5384877 Fax: +1-507-2840762
Received: December 15, 2013
Revised: February 28, 2014
Accepted: April 30, 2014
Published online: November 14, 2014
Core Tip

Core tip: Metformin has been shown to prevent the development of hepatocellular carcinoma (HCC) among patients with diabetes and chronic liver disease in retrospective studies. This agent results in inhibition of the mTOR pathway, integral to many malignancies. We investigated the role of metformin as a chemotherapeutic agent in HCC, by assessing whether its use in patients newly diagnosed with this cancer had improved survival as compared to diabetics on other hypoglycemic agents and those without diabetes. Our analysis clearly reveals that there is no overall survival benefit in using metformin for those patients newly diagnosed with HCC.