PDF(Pubmed)
Abstract：
To systematically review and evaluate metformin\'s potential impact on vestibular schwannoma (VS) growth.
PubMed, Cochrane Library, and Embase.
A retrospective cohort study was performed on sporadic VS patients undergoing initial observation who had at least two magnetic resonance imaging studies. Patients were stratified by metformin use during the observation period. Primary endpoint was VS growth, defined as at least a 2 mm increase in diameter. Survival free of tumor growth was evaluated between groups. Systematic review and meta-analysis were performed to produce a pooled odds ratio [OR]. Study heterogeneity was assessed and post-hoc power analysis was performed.
A total of 123 patients were included, of which 17% were taking metformin. Median patient age was 56.6 years (range, 25.1-84.5). There were no statistically significant differences between the groups. Survival analysis did not demonstrate a statistically significant difference in time to VS growth between groups (hazard ratio = 0.61, 95% confidence interval [CI] = 0.29-1.29). Furthermore, logistic regression analysis did not demonstrate a statistically significant difference between groups in the odds of VS growth (OR = 0.46, 95% CI = 0.17-1.27). Systematic review identified 3 studies. Meta-analysis suggested that metformin reduces the odds of developing VS growth (pooled OR = 0.45, 95% CI = 0.29-0.71). Studies demonstrated low between-study heterogeneity. Power analysis demonstrated a sample size of 220 patients with equal randomization would be required to prospectively identify a true difference with 80% power.
Metformin use may reduce the odds of VS growth. A randomized trial would be ideal to identify an unbiased estimate of metformin\'s effect on VS growth. Laryngoscope, 133:2066-2072, 2023.
PubMed, Cochrane Library, and Embase.
A retrospective cohort study was performed on sporadic VS patients undergoing initial observation who had at least two magnetic resonance imaging studies. Patients were stratified by metformin use during the observation period. Primary endpoint was VS growth, defined as at least a 2 mm increase in diameter. Survival free of tumor growth was evaluated between groups. Systematic review and meta-analysis were performed to produce a pooled odds ratio [OR]. Study heterogeneity was assessed and post-hoc power analysis was performed.
A total of 123 patients were included, of which 17% were taking metformin. Median patient age was 56.6 years (range, 25.1-84.5). There were no statistically significant differences between the groups. Survival analysis did not demonstrate a statistically significant difference in time to VS growth between groups (hazard ratio = 0.61, 95% confidence interval [CI] = 0.29-1.29). Furthermore, logistic regression analysis did not demonstrate a statistically significant difference between groups in the odds of VS growth (OR = 0.46, 95% CI = 0.17-1.27). Systematic review identified 3 studies. Meta-analysis suggested that metformin reduces the odds of developing VS growth (pooled OR = 0.45, 95% CI = 0.29-0.71). Studies demonstrated low between-study heterogeneity. Power analysis demonstrated a sample size of 220 patients with equal randomization would be required to prospectively identify a true difference with 80% power.
Metformin use may reduce the odds of VS growth. A randomized trial would be ideal to identify an unbiased estimate of metformin\'s effect on VS growth. Laryngoscope, 133:2066-2072, 2023.
摘要：
目的：系统评价二甲双胍对前庭神经鞘瘤(VS)生长的潜在影响。
方法：PubMed，科克伦图书馆,和Embase。
方法：对接受初步观察的散发性VS患者进行了一项回顾性队列研究，这些患者进行了至少两项磁共振成像研究。在观察期间通过使用二甲双胍对患者进行分层。主要终点是VS生长，定义为直径至少增加2毫米。在组间评估无肿瘤生长的存活率。进行系统评价和荟萃分析，以产生合并比值比[OR]。评估研究异质性并进行事后功效分析。
结果：共纳入123例患者，其中17%服用二甲双胍。患者年龄中位数为56.6岁（范围，25.1-84.5).组间无统计学意义的差异。生存分析未显示两组之间VS生长时间的统计学差异（风险比=0.61，95％置信区间[CI]=0.29-1.29）。此外，logistic回归分析未显示两组之间VS增长几率的统计学差异(OR=0.46,95%CI=0.17-1.27).系统评价确定了3项研究。荟萃分析表明，二甲双胍可降低发生VS生长的几率（合并OR=0.45，95％CI=0.29-0.71）。研究表明，研究间异质性较低。功效分析表明，将需要具有相同随机化的220名患者的样本量来前瞻性地确定具有80％功效的真实差异。
结论：使用二甲双胍可以降低VS生长的几率。随机试验是确定二甲双胍对VS生长影响的无偏估计的理想选择。喉镜,2023年。
方法：PubMed，科克伦图书馆,和Embase。
方法：对接受初步观察的散发性VS患者进行了一项回顾性队列研究，这些患者进行了至少两项磁共振成像研究。在观察期间通过使用二甲双胍对患者进行分层。主要终点是VS生长，定义为直径至少增加2毫米。在组间评估无肿瘤生长的存活率。进行系统评价和荟萃分析，以产生合并比值比[OR]。评估研究异质性并进行事后功效分析。
结果：共纳入123例患者，其中17%服用二甲双胍。患者年龄中位数为56.6岁（范围，25.1-84.5).组间无统计学意义的差异。生存分析未显示两组之间VS生长时间的统计学差异（风险比=0.61，95％置信区间[CI]=0.29-1.29）。此外，logistic回归分析未显示两组之间VS增长几率的统计学差异(OR=0.46,95%CI=0.17-1.27).系统评价确定了3项研究。荟萃分析表明，二甲双胍可降低发生VS生长的几率（合并OR=0.45，95％CI=0.29-0.71）。研究表明，研究间异质性较低。功效分析表明，将需要具有相同随机化的220名患者的样本量来前瞻性地确定具有80％功效的真实差异。
结论：使用二甲双胍可以降低VS生长的几率。随机试验是确定二甲双胍对VS生长影响的无偏估计的理想选择。喉镜,2023年。
