The impact of metformin use on survival outcomes in colorectal cancer: A systematic review and meta-analysis
Abstract
Background: Emerging research indicates that metformin exerts anticancer activity across multiple malignancies, including colorectal cancer (CRC). Yet, its prognostic influence in CRC remains uncertain due to conflicting evidence. This study examines the relationship between metformin administration and prognostic outcomes among CRC patients.
Methods: A thorough literature search was undertaken across PubMed, Web of Science, Scopus, and Google Scholar. Eligible studies consisted of cohort designs that reported hazard ratios (HRs) for all-cause mortality (ACM), disease-free survival (DFS), overall survival (OS), cancer-specific mortality (CSM), or recurrence-free survival (RFS). Pooled estimates were generated using random-effects models.
Results: A total of 31 cohort studies encompassing 167,683 participants were analyzed. Metformin use was linked to lower ACM (HR=0.79, 95 % CI: 0.70-0.90), reduced CSM (HR=0.80, 95 % CI: 0.69-0.94), and improved OS (HR=0.79, 95 % CI: 0.70-0.90), with the benefits most evident in diabetic populations. Among non-diabetic patients, no meaningful association with CSM was identified (HR=0.96, 95 % CI: 0.84-1.10), whereas diabetic patients exhibited a significant reduction (HR=0.77, 95 % CI: 0.63-0.93). No effect was observed for RFS (HR=1.00, 95 % CI: 0.96-1.05), and DFS demonstrated only a non-significant trend toward improvement (HR=0.78, 95 % CI: 0.59-1.04). Considerable heterogeneity was present and evidence of publication bias was noted for…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 167,683 participants or records.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.