Objective: Endometrial cancer (EC) is the most common gynecological
malignancy in economically developed countries. Documented risk factors
include diabetes mellitus and obesity. Metformin, a derivative of
biguanide, applied in treatment of type 2 diabetes, also has
anti-neoplastic effects. The analysis presented below represents an
attempt to determine the effects of metformin on clinical-pathological
variables of EC, linked to the morbidity and course of EC. Material and
Methods: 1,305 patients with EC were included in this retrospective
study, the control group consisted of 1,016 EC patients who were
diabetes-free. 144 patients with EC and type 2 diabetes treated with
metformin, and 145 patients with EC and type 2 diabetes treated with
other antidiabetic agents. The analyzed variables included age upon
diagnosis of EC, BMI, parity, clinical stage according to FIGO,
histological type of cancer (type I or type II EC), grading, type of
surgery, adjuvant treatment (radio- or chemotherapy), and comorbidities.
Results: EC in females with type 2 diabetes treated with metformin or
other antidiabetic agents were diagnosed at a more advanced age than
those in the control group. Both groups of patients with type 2 diabetes
manifested morbid obesity significantly more frequently than the control
group. Advanced stages of cancer were detected less frequently among
metformin users compared to the control group and among patients with
diabetes treated with other antidiabetic agents. Moreover, in the
metformin group, total abdominal hysterectomy and adnexectomy were less
common than in the remaining groups. Adjuvant radiotherapy was applied
more frequently in the metformin-treated group. Both groups of type 2
diabetes patients were also more likely to suffer from hypertension.
Conclusion: Compared to the control group, women with EC and diabetes
mellitus were diagnosed at a more advanced age. A lower percentage of
women with EC using metformin were diagnosed at advanced stages of EC
according to FIGO in contrast to the control group and the group with
diabetes treated with other antidiabetic agents. Patients treated with
metformin underwent TAHBSO less frequently, but radiotherapy was applied
more often. The present results show that type 2 diabetes patients also
suffer from hypertension more frequently regardless of the diabetes
treatment applied
