The Association of Metformin, Other Antidiabetic Medications, and Statins with the Prognosis of Hepatocellular Carcinoma in Patients with Type 2 Diabetes: A Retrospective Cohort Study
Iida Tuunanen,
Ari Hautakoski,
Heikki Huhtamäki,
Martti Arffman,
Reijo Sund,
Ulla Puistola,
Peeter Karihtala,
Arja Jukkola,
Elina Urpilainen
Affiliations
Iida Tuunanen
Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu, 90220 Oulu, Finland
Ari Hautakoski
Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
Heikki Huhtamäki
Research Unit of Mathematical Sciences, Faculty of Science, University of Oulu, 90014 Oulu, Finland
Martti Arffman
Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
Reijo Sund
Institute of Clinical Medicine, University of Eastern Finland, 70029 Kuopio, Finland
Ulla Puistola
Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu, 90220 Oulu, Finland
Peeter Karihtala
Department of Oncology, University of Helsinki, Helsinki University Hospital Comprehensive Cancer Center, 00029 Helsinki, Finland
Arja Jukkola
Department of Oncology and Radiotherapy, Tays Cancer Center, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, 33521 Tampere, Finland
Elina Urpilainen
Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu, 90220 Oulu, Finland
This study aimed to explore whether the prediagnostic use of metformin and statins is associated with the prognosis of patients with hepatocellular carcinoma (HCC) and type 2 diabetes. We identified 1383 eligible individuals who had both type 2 diabetes and HCC diagnosed between 1998 and 2017 from several Finnish registers. Cox models were fitted for cause-specific and all-cause mortality in relation to the use of antidiabetic medications and statins prior to the HCC diagnosis. Prediagnostic metformin use was associated with decreased overall mortality (hazard ratio 0.84, 95% confidence interval 0.74–0.94) compared with nonuse in patients with type 2 diabetes. Similarly, slightly decreased HCC mortality and other-cause mortality were observed among metformin users. The results were inconclusive regarding metformin use and both overall and HCC mortality among patients with localized HCC. No discernible contrast between statin users and nonusers was found in overall mortality nor HCC mortality in either the whole cohort or patients with localized cancer.
