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Absence of antitumor effects of metformin in sorafenib-treated patients with hepatocellular carcinoma recurrence after hepatic resection and liver transplantation
Ann Hepatobiliary Pancreat Surg 2018 Nov;22(4):297-304
Published online November 30, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Yong-Kyu Chung1, Shin Hwang1, Gi-Won Song1, Young-Joo Lee1, Ki-Hun Kim1, Chul-Soo Ahn1, Deok-Bog Moon1, Tae-Yong Ha1, Dong-Hwan Jung1, Gil-Chun Park1, Baek-Yeol Ryoo2, Sung-Gyu Lee1

Departments of 1Surgery and 2Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Received June 6, 2018; Revised June 10, 2018; Accepted June 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: Hepatocellular carcinoma (HCC) recurrence following hepatic resection (HR) and liver transplantation (LT) remains a great concern. We assessed the antitumor effects of metformin in patients treated with sorafenib for HCC recurrence after HR or LT. 
Methods: The two clinical retrospective studies involved metformin therapy of 304 HR patients and 74 LT recipients who were treated with sorafenib. 
Results: In the study involving patients who had undergone HR, death occurred in 245 of the 304 patients (80.6%) during a median follow-up of 10.2 months after sorafenib administration. The metformin HR group (group 1; n=40) showed no prognostic difference in progression-free and overall survival rates compared with the all-HR control group (group 3; n=241) and propensity score-matched HR control group (group 4; n=80). In the clinical study of recipients exposed to LT, death occurred in 62 of the 74 patients (83.8%) during a median follow-up of 13.6 months (range: 3-76 months) after sorafenib administration. The metformin LT group (group 5; n=14) showed no prognostic difference in progression-free and overall survival rates compared with the all-LT control group (group 7; n=43) and propensity score-matched LT control group (group 8; n=28). 
Conclusions: Our clinical studies demonstrated absence of synergistic antitumor effects of metformin. Further high-volume studies are necessary to assess the role of metformin in patients treated with sorafenib for advanced HCC.
Keywords : Diabetic mellitus; Hepatic resection; Metformin; Recurrence

 

November 2018, 22 (4)