Faculty Opinions recommendation of Metformin for primary colorectal cancer prevention in patients with diabetes: a case-control study in a US population.

e14158 Background: This aim of this case-control study was to assess the prognostic impact of the presence of liver metastases (LM) in patients operated on colorectal peritoneal carcinomatosis (PC) who underwent complete cytoreductive surgery (CRS) and LM resection followed by intraperitoneal chemotherapy. Methods: From a prospectively maintained database, all patients with colorectal PC and synchronous LM who underwent CRS followed by intraperitoneal chemotherapy, were manually matched to all identical patients with isolated PC, operated on over the same period, on the following matching criteria: age, peritoneal cancer index (PCI), site of the primary colorectal cancer (colon or rectum), lymph node involvement on the primary colorectal cancer specimen (pN), and postoperative chemotherapy. Results: From 1993 to 2009, 37 patients with PC and LM were matched to 61 patients with isolated PC. After a mean follow-up of 36 months, 3-year overall (OS) and disease free survival rates were significantly lower in patients with PC and LM, respectively 40% and 66% (p=0.04) and 6% and 27% (p=0.001). In Cox regression analysis, a PCI ≥ 12 (Odds-ratio (OR): 4.6), a pN+ status (OR: 3.3), no adjuvant chemotherapy (OR: 3.0) and presence of LM (OR: 2.0) were identified as independent factors of poor OS. Thus, 3 groups could be identified: 1) patients with a low PCI (<12) and no LM, with an associated a median OS of 76 months; 2) patients with a low PCI (<12) and 1 or 2 LM, with an associated OS of 40 months; and 3) patients with a high PCI (≥12) or patients with ≥ 3 LM, with an associated OS of 27 months. Conclusions: This first case-control study confirms that prolonged survival can be achieved in highly selected patients operated on limited carcinomatosis and liver metastases less than 3. When the peritoneal and the liver involvement are greater, the complete surgical treatment followed by intraperitoneal chemotherapy should be discussed according to criteria of aggressiveness of the tumor disease.

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ASA, NSAIDs, Coxibs and Colorectal Cancer Prevention — How Far Have We Come?

Canadian Journal of Gastroenterology ◽

10.1155/2004/862152 ◽

2004 ◽

Vol 18 (7) ◽

pp. 467-468

Author(s):

Martin Fishman

Keyword(s):

Colorectal Cancer ◽

Drug Exposure ◽

Case Control Study ◽

Case Control ◽

Provincial Government ◽

Inflammatory Drugs ◽

Colorectal Cancer Prevention ◽

Nested Case Control ◽

Control Study ◽

Specific Inhibitors

This paper described a nested case-control study on all Quebec patients over 65 years of age who underwent total colonic imaging or surgery for colorectal cancer (CRC) during a specified six-month period without similar testing in the preceding year. Information from the provincial government database was collected for each subject to estimate the consumption of prescription acetylsalicylic acid (ASA), standard nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2- specific inhibitors (coxibs) during the previous year. Of 2568 subjects, 730 were found to have at least one adenoma (but not carcinoma) and 129 were found to have CRC (with or without adenoma). Patients with and without adenoma or carcinoma were compared for type, amount and duration of drug exposure to determine if there was a protective effect. Rofecoxib and NSAIDs were associated with reduced incidence of colorectal adenoma (CRA), and these drugs and celecoxib protected against CRA and CRC.

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Association between DPP-4 inhibitors and events of colorectal and liver cancers in patients with diabetes receiving second-line agents: a nested case-control study

10.21203/rs.3.rs-30941/v1 ◽

2020 ◽

Author(s):

Chu-Lin Chou ◽

Shu-Hui Juan ◽

Hsi-Hsien Chen ◽

Chih-Chin Kao ◽

Yueh-Lin Wu ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Cancer ◽

Cancer Risk ◽

Case Control Study ◽

Case Control ◽

Second Line ◽

Liver Cancers ◽

Patients With Diabetes ◽

Nested Case Control ◽

Control Study

Abstract Background and aim: Several studies showed plasma dipeptidyl peptidase-4 (DPP4) levels were significantly lower in patients with colorectal and liver cancers, and animal studies also showed DPP4 inhibitors (DPP4is) have procarcinogenic effects in colorectal cancer. The aims of this study were to investigate the association between cumulative defined daily dose (cDDD) of DPP4is exposure and risks of liver and colorectal cancers in patients with type 2 diabetes mellitus. Methods In this nested case-control study, we identified 268,520 patients with diabetes receiving DPP4is as second-line agents between March 1, 2009, and December 31, 2013, from Taiwan’s National Health Insurance Research Database, Taiwan Cancer Registry, and National Death Registry of Taiwan. Of these, 948 and 990 patients newly were diagnosed with liver and colorectal cancer, respectively. The amount of DPP4is were divided into three groups (low, medium, and high) based on the interquartile range of the cDDD of the DPP4is. Results: The data showed that the low cDDD of DPP-4is was associated with a reducing risk of colorectal cancer [adjusted odds ratio (OR), 0.49; 95% CI, 0.32–0.75; P = 0.001]. However, the high cDDD of DPP-4is was associated with an increasing risk of colorectal cancer (adjusted OR, 1.86; 95% CI, 1.32–2.61; P < 0.001). No association between DPP4is use and liver cancer risk was observed. Conclusions The novel finding of this nested case study revealed a J-shaped association between the cDDD of DPP-4is and colorectal cancer risk, but not liver cancer risk. A large-based longitudinal investigation is necessary to determine whether long-term DPP4is exposure increase colorectal cancer risk.

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