Effect of metformin on tumor treatment in patients with endometrial cancer: a retrospective cohort study

Abstract Purpose: To explore the effects of weight management combined with metformin on the treatment effect, weight management, and glucose and lipid metabolism in patients with endometrial cancer(EC). Methods: A retrospective cohort study was conducted on patients with EC who underwent weight management at the Department of Gynecology, Peking University People's Hospital, from January 2017 to May 2024. Participants were divided into two groups: 1) the combination therapy group (which received weight management along with metformin) and 2) the weight management group. The primary outcomes measured included treatment outcome, weight, body mass index (BMI), and metabolic indicators. Results: A total of 157 patients were included, 41 patients were included in the weight management combined with metformin group, and 116 patients were included in the weight management group. The statistical results showed that there was a significant difference in the changes in pathological results before and after follow-up between the two groups of patients (P = 0.015). The patients using metformin had a better treatment outcome. In the univariate analysis, whether to use metformin, low-density lipoprotein cholesterol (LDL-C), and age were independent influencing factors for the treatment effect of EC. Conclusion: Weight management combined with metformin can improve the treatment outcome of patients with EC, and the treatment effect decreases with age. The use of metformin has a complex regulatory effect on lipid metabolism in patients with weight management.