Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410000, China; Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, Hunan, 410000, China; Institute of Oral Precancerous Lesions, Central South University, Changsha, Hunan, 410000, China.
Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, 410000, China.
Surg Oncol. 2020 Dec;35:453-459. doi: 10.1016/j.suronc.2020.09.023. Epub 2020 Oct 8.
To investigate the impact of type 2 diabetes mellitus (T2DM) and metformin treatment on the prognosis of oral squamous cell carcinoma (OSCC) patients received radical surgical treatment.
Eight hundred and fifty-two patients with OSCC between January 2011 and January 2015 were included in the cohort study. Propensity score analysis was used to balance the characteristics of patients with or without T2DM and those of patients with T2DM treated with or without metformin. Five-year OSCC-free survival (OFS) was used to evaluate the prognosis of OSCC patients.
Two hundred and sixty-nine patients without T2DM and 138 patients with T2DM were selected after the propensity score matching. The 5-year OFS of patients with T2DM was significantly lower than that of those without T2DM, both before (P = 0.019) and after (P = 0.014) the propensity score matching. Forty-four metformin users of OSCC patients with T2DM and 44 patients never users were further compared after the propensity score matching. The 5-year OFS of metformin users was significantly higher than that of metformin never users both before (P = 0.005) and after (P = 0.002) the propensity score matching.
T2DM is associated with a higher risk of OSCC recurrence that can be reduced by metformin treatment.
研究 2 型糖尿病（T2DM）和二甲双胍治疗对接受根治性手术治疗的口腔鳞状细胞癌（OSCC）患者预后的影响。
纳入了 2011 年 1 月至 2015 年 1 月间的 852 例 OSCC 患者进行队列研究。采用倾向评分分析来平衡有无 T2DM 患者以及 T2DM 合并二甲双胍治疗与未治疗患者的特征。采用无复发生存率（OFS）评估 OSCC 患者的预后。
经倾向评分匹配后，选择了 269 例无 T2DM 患者和 138 例 T2DM 患者。T2DM 患者的 5 年 OFS 明显低于无 T2DM 患者，匹配前后均如此（P = 0.019 和 P = 0.014）。在匹配后，进一步比较了 44 例 T2DM 合并 OSCC 且使用二甲双胍的患者和 44 例从未使用过二甲双胍的患者。二甲双胍使用者的 5 年 OFS 明显高于二甲双胍未使用者，匹配前后均如此（P = 0.005 和 P = 0.002）。
T2DM 与 OSCC 复发风险增加相关，而二甲双胍治疗可降低这种风险。
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