# The Association of Metformin, Other Antidiabetic Medications, and Statins with the Prognosis of Hepatocellular Carcinoma in Patients with Type 2 Diabetes: A Retrospective Cohort Study

## TL;DR

This study found that using metformin before diagnosis may improve survival in people with type 2 diabetes and liver cancer.

## Contribution

The study is the first to examine the association of prediagnostic metformin and statin use with HCC prognosis in patients with type 2 diabetes.

## Key findings

- Prediagnostic metformin use was linked to lower overall mortality in patients with type 2 diabetes and HCC.
- No significant association was found between statin use and mortality outcomes in HCC patients.
- Results were inconclusive for metformin's effect on localized HCC mortality.

## Abstract

This study aimed to explore whether the prediagnostic use of metformin and statins is associated with the prognosis of patients with hepatocellular carcinoma (HCC) and type 2 diabetes. We identified 1383 eligible individuals who had both type 2 diabetes and HCC diagnosed between 1998 and 2017 from several Finnish registers. Cox models were fitted for cause-specific and all-cause mortality in relation to the use of antidiabetic medications and statins prior to the HCC diagnosis. Prediagnostic metformin use was associated with decreased overall mortality (hazard ratio 0.84, 95% confidence interval 0.74–0.94) compared with nonuse in patients with type 2 diabetes. Similarly, slightly decreased HCC mortality and other-cause mortality were observed among metformin users. The results were inconclusive regarding metformin use and both overall and HCC mortality among patients with localized HCC. No discernible contrast between statin users and nonusers was found in overall mortality nor HCC mortality in either the whole cohort or patients with localized cancer.