Metformin exposure is associated with improved progression-free survival in diabetic patients after resection for early-stage non–small cell lung cancer
Abstract Objective There are little clinical data assessing the antineoplastic effect of metformin in patients with non–small cell lung cancer. We hypothesized that in diabetic patients undergoing pulmonary resection for early-stage non–small cell lung cancer, metformin exposure is associated with i...
Gespeichert in:
| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2016-07, Vol.152 (1), p.55-61.e1 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 61.e1 |
|---|---|
| container_issue | 1 |
| container_start_page | 55 |
| container_title | The Journal of thoracic and cardiovascular surgery |
| container_volume | 152 |
| creator | Medairos, Robert A., BS Clark, James, MS Holoubek, Simon, DO Kubasiak, John C., MD Pithadia, Ravi, MD Hamid, Fatima, MD Chmielewski, Gary W., MD Warren, William H., MD Basu, Sanjib, PhD Borgia, Jeffrey A., PhD Liptay, Michael J., MD Seder, Christopher W., MD |
| description | Abstract Objective There are little clinical data assessing the antineoplastic effect of metformin in patients with non–small cell lung cancer. We hypothesized that in diabetic patients undergoing pulmonary resection for early-stage non–small cell lung cancer, metformin exposure is associated with improved survival. Methods An institutional database was used to identify patients with stage I or II non–small cell lung cancer who underwent pulmonary resection between 2004 and 2013. Patients were divided into 3 cohorts: type II diabetic patients with metformin exposure (cohort A, n = 81), type II diabetic patients without metformin exposure (cohort B, n = 57), and nondiabetic individuals (cohort C, n = 77). Univariate, multivariate, and propensity-matched analyses were performed to assess progression-free and overall survivals between groups. Results A total of 215 patients with stage I and II non–small cell lung cancer treated with surgical resection were identified for analysis with a median follow-up of 19.5 months. Patients in cohort A had lower T- and N-stage tumors than those in cohorts B or C. However, on multivariate analysis adjusting for age, gender, and T and N stage, progression-free survival was greater for cohort A than cohort B (hazard ratio [HR], 0.410; 95% confidence interval, 0.199-0.874; P = .022) or cohort C (HR, 0.415; 95% confidence interval, 0.201-0.887; P = .017). Likewise, when propensity-matched analyses were performed, cohort A demonstrated a trend toward improved progression-free survival compared with cohort B ( P = .057; HR, 0.44; c-statistic = 0.832) and improved progression-free survival compared with cohort C ( P = .02; HR, 0.41; c-statistic = 0.843). No differences were observed in overall survival. Conclusions Metformin exposure in diabetic patients with early-stage non–small cell lung cancer may be associated with improved progression-free survival, but no effect was seen on overall survival. Further studies are warranted to evaluate if there is a therapeutic role for metformin in the treatment of non–small cell lung cancer. |
| doi_str_mv | 10.1016/j.jtcvs.2016.03.094 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1799836721</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522316301179</els_id><sourcerecordid>1799836721</sourcerecordid><originalsourceid>FETCH-LOGICAL-c389t-4f52093e0de862028c1aaf45610f730b620917ffc19b12afac622d284a9209cd3</originalsourceid><addsrcrecordid>eNqFUsuO1DAQtBCInV34AiTkI5cEPyYPH0BCK2CRFnEAJG6Wx2kPDkk82E5gbvwDNz6PL6HDLBy4cHGr7apqd1cT8oCzkjNeP-7LPtsllQKTksmSqe0tsuFMNUXdVh9ukw1jQhSVEPKMnKfUM8YaxtVdciYaXjWKtxvy4zVkF-LoJwpfDyHNEahP1KQUrDcZOvrF54_Uj4cYFsww7COk5MNUuAhAkbH4xQwUFTpvdpC9pQeTPUwZdVyGSJEANiOFYikKJg7HImWzBzqF6ee372k0w0At4DHM055aM1mI98gdZ4YE92_iBXn_4vm7y6vi-s3LV5fPrgsrW5WLrasEUxJYB20tmGgtN8Ztq5oz10i2wzvFG-csVzsujDO2FqIT7dYofLGdvCCPTrrY2-cZUtajT-tnzARhTpo3SrWybgRHqDxBbQwpRXD6EP1o4lFzpldTdK9_m6JXUzSTGk1B1sObAvNuhO4v548LCHhyAgC2uXiIOlmcn4XORxyc7oL_T4Gn__Dt4CdvzfAJjpD6MMcJJ6i5TkIz_Xbdi3UteC0Zx_bkL6nAuJU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1799836721</pqid></control><display><type>article</type><title>Metformin exposure is associated with improved progression-free survival in diabetic patients after resection for early-stage non–small cell lung cancer</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Medairos, Robert A., BS ; Clark, James, MS ; Holoubek, Simon, DO ; Kubasiak, John C., MD ; Pithadia, Ravi, MD ; Hamid, Fatima, MD ; Chmielewski, Gary W., MD ; Warren, William H., MD ; Basu, Sanjib, PhD ; Borgia, Jeffrey A., PhD ; Liptay, Michael J., MD ; Seder, Christopher W., MD</creator><creatorcontrib>Medairos, Robert A., BS ; Clark, James, MS ; Holoubek, Simon, DO ; Kubasiak, John C., MD ; Pithadia, Ravi, MD ; Hamid, Fatima, MD ; Chmielewski, Gary W., MD ; Warren, William H., MD ; Basu, Sanjib, PhD ; Borgia, Jeffrey A., PhD ; Liptay, Michael J., MD ; Seder, Christopher W., MD</creatorcontrib><description>Abstract Objective There are little clinical data assessing the antineoplastic effect of metformin in patients with non–small cell lung cancer. We hypothesized that in diabetic patients undergoing pulmonary resection for early-stage non–small cell lung cancer, metformin exposure is associated with improved survival. Methods An institutional database was used to identify patients with stage I or II non–small cell lung cancer who underwent pulmonary resection between 2004 and 2013. Patients were divided into 3 cohorts: type II diabetic patients with metformin exposure (cohort A, n = 81), type II diabetic patients without metformin exposure (cohort B, n = 57), and nondiabetic individuals (cohort C, n = 77). Univariate, multivariate, and propensity-matched analyses were performed to assess progression-free and overall survivals between groups. Results A total of 215 patients with stage I and II non–small cell lung cancer treated with surgical resection were identified for analysis with a median follow-up of 19.5 months. Patients in cohort A had lower T- and N-stage tumors than those in cohorts B or C. However, on multivariate analysis adjusting for age, gender, and T and N stage, progression-free survival was greater for cohort A than cohort B (hazard ratio [HR], 0.410; 95% confidence interval, 0.199-0.874; P = .022) or cohort C (HR, 0.415; 95% confidence interval, 0.201-0.887; P = .017). Likewise, when propensity-matched analyses were performed, cohort A demonstrated a trend toward improved progression-free survival compared with cohort B ( P = .057; HR, 0.44; c-statistic = 0.832) and improved progression-free survival compared with cohort C ( P = .02; HR, 0.41; c-statistic = 0.843). No differences were observed in overall survival. Conclusions Metformin exposure in diabetic patients with early-stage non–small cell lung cancer may be associated with improved progression-free survival, but no effect was seen on overall survival. Further studies are warranted to evaluate if there is a therapeutic role for metformin in the treatment of non–small cell lung cancer.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2016.03.094</identifier><identifier>PMID: 27157918</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Carcinoma, Non-Small-Cell Lung - complications ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Cardiothoracic Surgery ; diabetes ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Disease-Free Survival ; Female ; Humans ; Hypoglycemic Agents - therapeutic use ; lung cancer ; Lung Neoplasms - complications ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Male ; Metformin ; Metformin - therapeutic use ; Neoplasm Recurrence, Local - prevention & control ; Neoplasm Staging ; outcomes ; Proportional Hazards Models ; survival</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2016-07, Vol.152 (1), p.55-61.e1</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2016 The American Association for Thoracic Surgery</rights><rights>Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-4f52093e0de862028c1aaf45610f730b620917ffc19b12afac622d284a9209cd3</citedby><cites>FETCH-LOGICAL-c389t-4f52093e0de862028c1aaf45610f730b620917ffc19b12afac622d284a9209cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522316301179$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27157918$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Medairos, Robert A., BS</creatorcontrib><creatorcontrib>Clark, James, MS</creatorcontrib><creatorcontrib>Holoubek, Simon, DO</creatorcontrib><creatorcontrib>Kubasiak, John C., MD</creatorcontrib><creatorcontrib>Pithadia, Ravi, MD</creatorcontrib><creatorcontrib>Hamid, Fatima, MD</creatorcontrib><creatorcontrib>Chmielewski, Gary W., MD</creatorcontrib><creatorcontrib>Warren, William H., MD</creatorcontrib><creatorcontrib>Basu, Sanjib, PhD</creatorcontrib><creatorcontrib>Borgia, Jeffrey A., PhD</creatorcontrib><creatorcontrib>Liptay, Michael J., MD</creatorcontrib><creatorcontrib>Seder, Christopher W., MD</creatorcontrib><title>Metformin exposure is associated with improved progression-free survival in diabetic patients after resection for early-stage non–small cell lung cancer</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Abstract Objective There are little clinical data assessing the antineoplastic effect of metformin in patients with non–small cell lung cancer. We hypothesized that in diabetic patients undergoing pulmonary resection for early-stage non–small cell lung cancer, metformin exposure is associated with improved survival. Methods An institutional database was used to identify patients with stage I or II non–small cell lung cancer who underwent pulmonary resection between 2004 and 2013. Patients were divided into 3 cohorts: type II diabetic patients with metformin exposure (cohort A, n = 81), type II diabetic patients without metformin exposure (cohort B, n = 57), and nondiabetic individuals (cohort C, n = 77). Univariate, multivariate, and propensity-matched analyses were performed to assess progression-free and overall survivals between groups. Results A total of 215 patients with stage I and II non–small cell lung cancer treated with surgical resection were identified for analysis with a median follow-up of 19.5 months. Patients in cohort A had lower T- and N-stage tumors than those in cohorts B or C. However, on multivariate analysis adjusting for age, gender, and T and N stage, progression-free survival was greater for cohort A than cohort B (hazard ratio [HR], 0.410; 95% confidence interval, 0.199-0.874; P = .022) or cohort C (HR, 0.415; 95% confidence interval, 0.201-0.887; P = .017). Likewise, when propensity-matched analyses were performed, cohort A demonstrated a trend toward improved progression-free survival compared with cohort B ( P = .057; HR, 0.44; c-statistic = 0.832) and improved progression-free survival compared with cohort C ( P = .02; HR, 0.41; c-statistic = 0.843). No differences were observed in overall survival. Conclusions Metformin exposure in diabetic patients with early-stage non–small cell lung cancer may be associated with improved progression-free survival, but no effect was seen on overall survival. Further studies are warranted to evaluate if there is a therapeutic role for metformin in the treatment of non–small cell lung cancer.</description><subject>Aged</subject><subject>Carcinoma, Non-Small-Cell Lung - complications</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Cardiothoracic Surgery</subject><subject>diabetes</subject><subject>Diabetes Mellitus</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>lung cancer</subject><subject>Lung Neoplasms - complications</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Metformin</subject><subject>Metformin - therapeutic use</subject><subject>Neoplasm Recurrence, Local - prevention & control</subject><subject>Neoplasm Staging</subject><subject>outcomes</subject><subject>Proportional Hazards Models</subject><subject>survival</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUsuO1DAQtBCInV34AiTkI5cEPyYPH0BCK2CRFnEAJG6Wx2kPDkk82E5gbvwDNz6PL6HDLBy4cHGr7apqd1cT8oCzkjNeP-7LPtsllQKTksmSqe0tsuFMNUXdVh9ukw1jQhSVEPKMnKfUM8YaxtVdciYaXjWKtxvy4zVkF-LoJwpfDyHNEahP1KQUrDcZOvrF54_Uj4cYFsww7COk5MNUuAhAkbH4xQwUFTpvdpC9pQeTPUwZdVyGSJEANiOFYikKJg7HImWzBzqF6ee372k0w0At4DHM055aM1mI98gdZ4YE92_iBXn_4vm7y6vi-s3LV5fPrgsrW5WLrasEUxJYB20tmGgtN8Ztq5oz10i2wzvFG-csVzsujDO2FqIT7dYofLGdvCCPTrrY2-cZUtajT-tnzARhTpo3SrWybgRHqDxBbQwpRXD6EP1o4lFzpldTdK9_m6JXUzSTGk1B1sObAvNuhO4v548LCHhyAgC2uXiIOlmcn4XORxyc7oL_T4Gn__Dt4CdvzfAJjpD6MMcJJ6i5TkIz_Xbdi3UteC0Zx_bkL6nAuJU</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Medairos, Robert A., BS</creator><creator>Clark, James, MS</creator><creator>Holoubek, Simon, DO</creator><creator>Kubasiak, John C., MD</creator><creator>Pithadia, Ravi, MD</creator><creator>Hamid, Fatima, MD</creator><creator>Chmielewski, Gary W., MD</creator><creator>Warren, William H., MD</creator><creator>Basu, Sanjib, PhD</creator><creator>Borgia, Jeffrey A., PhD</creator><creator>Liptay, Michael J., MD</creator><creator>Seder, Christopher W., MD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160701</creationdate><title>Metformin exposure is associated with improved progression-free survival in diabetic patients after resection for early-stage non–small cell lung cancer</title><author>Medairos, Robert A., BS ; Clark, James, MS ; Holoubek, Simon, DO ; Kubasiak, John C., MD ; Pithadia, Ravi, MD ; Hamid, Fatima, MD ; Chmielewski, Gary W., MD ; Warren, William H., MD ; Basu, Sanjib, PhD ; Borgia, Jeffrey A., PhD ; Liptay, Michael J., MD ; Seder, Christopher W., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-4f52093e0de862028c1aaf45610f730b620917ffc19b12afac622d284a9209cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Carcinoma, Non-Small-Cell Lung - complications</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Cardiothoracic Surgery</topic><topic>diabetes</topic><topic>Diabetes Mellitus</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>lung cancer</topic><topic>Lung Neoplasms - complications</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Metformin</topic><topic>Metformin - therapeutic use</topic><topic>Neoplasm Recurrence, Local - prevention & control</topic><topic>Neoplasm Staging</topic><topic>outcomes</topic><topic>Proportional Hazards Models</topic><topic>survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Medairos, Robert A., BS</creatorcontrib><creatorcontrib>Clark, James, MS</creatorcontrib><creatorcontrib>Holoubek, Simon, DO</creatorcontrib><creatorcontrib>Kubasiak, John C., MD</creatorcontrib><creatorcontrib>Pithadia, Ravi, MD</creatorcontrib><creatorcontrib>Hamid, Fatima, MD</creatorcontrib><creatorcontrib>Chmielewski, Gary W., MD</creatorcontrib><creatorcontrib>Warren, William H., MD</creatorcontrib><creatorcontrib>Basu, Sanjib, PhD</creatorcontrib><creatorcontrib>Borgia, Jeffrey A., PhD</creatorcontrib><creatorcontrib>Liptay, Michael J., MD</creatorcontrib><creatorcontrib>Seder, Christopher W., MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Medairos, Robert A., BS</au><au>Clark, James, MS</au><au>Holoubek, Simon, DO</au><au>Kubasiak, John C., MD</au><au>Pithadia, Ravi, MD</au><au>Hamid, Fatima, MD</au><au>Chmielewski, Gary W., MD</au><au>Warren, William H., MD</au><au>Basu, Sanjib, PhD</au><au>Borgia, Jeffrey A., PhD</au><au>Liptay, Michael J., MD</au><au>Seder, Christopher W., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metformin exposure is associated with improved progression-free survival in diabetic patients after resection for early-stage non–small cell lung cancer</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2016-07-01</date><risdate>2016</risdate><volume>152</volume><issue>1</issue><spage>55</spage><epage>61.e1</epage><pages>55-61.e1</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Abstract Objective There are little clinical data assessing the antineoplastic effect of metformin in patients with non–small cell lung cancer. We hypothesized that in diabetic patients undergoing pulmonary resection for early-stage non–small cell lung cancer, metformin exposure is associated with improved survival. Methods An institutional database was used to identify patients with stage I or II non–small cell lung cancer who underwent pulmonary resection between 2004 and 2013. Patients were divided into 3 cohorts: type II diabetic patients with metformin exposure (cohort A, n = 81), type II diabetic patients without metformin exposure (cohort B, n = 57), and nondiabetic individuals (cohort C, n = 77). Univariate, multivariate, and propensity-matched analyses were performed to assess progression-free and overall survivals between groups. Results A total of 215 patients with stage I and II non–small cell lung cancer treated with surgical resection were identified for analysis with a median follow-up of 19.5 months. Patients in cohort A had lower T- and N-stage tumors than those in cohorts B or C. However, on multivariate analysis adjusting for age, gender, and T and N stage, progression-free survival was greater for cohort A than cohort B (hazard ratio [HR], 0.410; 95% confidence interval, 0.199-0.874; P = .022) or cohort C (HR, 0.415; 95% confidence interval, 0.201-0.887; P = .017). Likewise, when propensity-matched analyses were performed, cohort A demonstrated a trend toward improved progression-free survival compared with cohort B ( P = .057; HR, 0.44; c-statistic = 0.832) and improved progression-free survival compared with cohort C ( P = .02; HR, 0.41; c-statistic = 0.843). No differences were observed in overall survival. Conclusions Metformin exposure in diabetic patients with early-stage non–small cell lung cancer may be associated with improved progression-free survival, but no effect was seen on overall survival. Further studies are warranted to evaluate if there is a therapeutic role for metformin in the treatment of non–small cell lung cancer.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27157918</pmid><doi>10.1016/j.jtcvs.2016.03.094</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-5223 |
| ispartof | The Journal of thoracic and cardiovascular surgery, 2016-07, Vol.152 (1), p.55-61.e1 |
| issn | 0022-5223 1097-685X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1799836721 |
| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Carcinoma, Non-Small-Cell Lung - complications Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - surgery Cardiothoracic Surgery diabetes Diabetes Mellitus Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Disease-Free Survival Female Humans Hypoglycemic Agents - therapeutic use lung cancer Lung Neoplasms - complications Lung Neoplasms - pathology Lung Neoplasms - surgery Male Metformin Metformin - therapeutic use Neoplasm Recurrence, Local - prevention & control Neoplasm Staging outcomes Proportional Hazards Models survival |
| title | Metformin exposure is associated with improved progression-free survival in diabetic patients after resection for early-stage non–small cell lung cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T23%3A44%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Metformin%20exposure%20is%20associated%20with%20improved%20progression-free%20survival%20in%20diabetic%20patients%20after%20resection%20for%20early-stage%20non%E2%80%93small%20cell%20lung%20cancer&rft.jtitle=The%20Journal%20of%20thoracic%20and%20cardiovascular%20surgery&rft.au=Medairos,%20Robert%20A.,%20BS&rft.date=2016-07-01&rft.volume=152&rft.issue=1&rft.spage=55&rft.epage=61.e1&rft.pages=55-61.e1&rft.issn=0022-5223&rft.eissn=1097-685X&rft_id=info:doi/10.1016/j.jtcvs.2016.03.094&rft_dat=%3Cproquest_cross%3E1799836721%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1799836721&rft_id=info:pmid/27157918&rft_els_id=S0022522316301179&rfr_iscdi=true |