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Research Paper|Volume 11, Issue 17|pp 7197—7205

A cohort study of antihyperglycemic medication exposure and survival in patients with gastric cancer

Audrius Dulskas1,2,3, Ausvydas Patasius4,5, Donata Linkeviciute-Ulinskiene6, Lina Zabuliene3, Giedre Smailyte4,5
  • 1Department of Abdominal and General Surgery and Oncology, National Cancer Institute, Vilnius LT-08406, Lithuania
  • 2University of Applied Sciences, Faculty of Health Care, Vilnius ELT-08303, Lithuania
  • 3Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
  • 4Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius LT-08406, Lithuania
  • 5Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
  • 6Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
Received: July 12, 2019Accepted: August 22, 2019Published: September 13, 2019
https://doi.org/10.18632/aging.102245

Copyright © 2019 Dulskas et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: We aimed to estimate survival in gastric cancer patients with type 2 diabetes mellitus (T2DM) using different antihyperglycemic medication.

Methods: Patients with gastric cancer and diabetes between 2003-2013 were identified form The Lithuanian Cancer Registry and The National Health Insurance Fund database. Cohort members were classified into five groups: four groups of T2DM patients according to treatment: metformin users; metformin and other medication users; sulphonylurea users; insulin and other medication users; and non-diabetic group. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate gastric cancer-specific survival and overall survival.

Results: 8423 patients met eligibility criteria. Survival analysis showed no differences in gastric cancer-specific survival between non-diabetic and diabetic patient groups. Better survival was observed in the groups of patients using antihyperglycemic medication combinations with metformin, metformin alone or insulin. Lowest survival was observed in diabetic patients who were sulphonylurea users. Survival analysis comparing overall survival between non-diabetic and diabetic patients (p = 0.89) showed no evidence of survival difference between groups and survival differences between antihyperglycemic medication user groups were of borderline significance (p = 0.052).

Conclusions: Antihyperglycemic medication use was not associated with a significant effect on survival in patients with gastric cancer and T2DM.