Protective Effect of Oral Antidiabetic Medicines Against Mechanical Ileus Development and Its Impact on Metastatic Colon Cancer Survival
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Previous studies have shown that the use of metformin improves overall survival (OS) in colorectal cancer. Furthermore, previous studies have shown that ileus is a poor prognostic factor in colorectal cancer. This study examined the role of metformin and other oral antidiabetic drugs in the development of ileus and their contribution to OS in colorectal cancer, as well as the effect of ileus on OS in metastatic colorectal cancer. Materials and Methods In this retrospective study, all patients with metastatic colon cancer followed at the Oncology Clinic of Aydın Adnan Menderes University between 2020 and 2025 were retrospectively screened. Patients who developed ileus and those who did not were compared to examine the potential effect of OAD use on ileus development. Additionally, the impact of the presence of ileus on disease prognosis was evaluated. Multivariate binary logistic regression models were constructed to adjust for clinical confounders. Results The mean age of the 244 patients included in the study was \(\:66.19\pm\:12.49\) years. All patients were clinically Stage IV (100%). OAD use was detected in 20.5% (\(\:n=50\)) of the patients, with metformin being the most common (18.9%, \(\:n=46\)). Ileus developed in 13.5% (\(\:n=33\)) of the cohort. In the comparative analysis, the presence of diabetes mellitus (\(\:p=0.027\)), general OAD use (\(\:p=0.027\)), and specifically metformin use (\(\:p=0.012\)) were significantly higher in patients who did not develop ileus. In the multivariate logistic regression analysis, general OAD use was identified as an independent protective factor reducing the risk of ileus (aOR: 0.214, 95% CI: 0.049–0.935, \(\:p=0.040\)). Similarly, metformin use independently reduced the odds of ileus (aOR: 0.112, 95% CI: 0.015–0.847, \(\:p=0.034\)). Conversely, the presence of lung metastasis was associated with a 2.47-fold independent increase in ileus risk (aOR: 2.475, 95% CI: 1.138–5.383, \(\:p=0.022\)). Kaplan-Meier analysis revealed that the median OS was significantly longer in patients who developed ileus compared to those who did not (24.60 months vs. 17.43 months, \(\:p=0.046\)). Conclusion Metformin and general OAD use significantly and independently reduce the risk of ileus development in patients with metastatic colon cancer. Contrary to conventional expectations, metastatic patients presenting with ileus may achieve longer survival times, potentially due to timely palliative surgical interventions that reduce tumor burden.
Source: Research Square
Language: English
Subfield: Molecular Biology
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7204529670