胃癌（GC）是全球最常见的癌症之一，也是死因之一。多项研究调查了二甲双胍对于糖尿病患者胃切除术后整体生存（OS）、癌症特异性生存（CSS）、无复发生存期（RFS）和复发率的影响，但结果互相矛盾。本次荟萃分析旨在评估二甲双胍与磺酰脲类化合物在糖尿病患者胃切除术后糖尿病患者OS、CSS、RFS和复发率方面的效果。我们在Scopus、Google Scholar、PubMed、Web of Science和Embassy数据库中回顾了以相应MESH词为基础的文献直至2022年9月。纳入了所有评估二甲双胍对胃切除手术糖尿病患者生存的观察性研究。使用危险比（HR）和95%置信区间来估计效应大小。使用Egger检验评估发表偏倚。总共包括了9项研究，共245,387例进行胃切除手术的GC患者。使用二甲双胍明显增加了OS率（HR：0.81，95% CI：0.78，0.86，P：0.001，I2：4.5%）、CSS率（HR：0.72，95% CI：0.63，0.81，P：0.011，I2=0%）和RFS率（HR：719，95% CI：0.524，0.986，P：0.001），并减少了胃切除术后的复发率（HR：0.83，95% CI：0.77，0.87，P：0.001，I2：0%）。二甲双胍的使用与亚洲人群中OS和CSS率的增加以及复发率的减少显著相关，而在西方人群中效果较小。对于患有GC的糖尿病患者，二甲双胍的使用可能与改善OS、CSS、RFS和胃切除术后降低复发率相关，尤其在亚洲人群中。© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Gastric cancer (GC) is one of the most common worldwide cancers and causes of death. Various studies have investigated the effect of metformin on overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and recurrence rate in diabetic patients after gastrectomy, and their results have been contradictory. This meta-analysis aimed to evaluate the effect of metformin use compared to sulfonylurea compounds with OS, CSS, RFS, and recurrence rate after gastrectomy in diabetic patients.We reviewed the Scopus, Google Scholar, PubMed, Web of Science, and Embassy databases until September 2022 based on appropriate MESH terms. All observational studies that evaluated the effect of metformin on survival in diabetic patients who underwent surgery for GC were included. The hazard ratio (HR) with a 95% confidence interval was used to estimate the effect size. The Egger test was used to evaluate publication bias.Overall, nine studies, including 245,387 GC patients who underwent surgery, were included. The use of metformin significantly increased the OS rate (HR: 0.81, 95% CI: 0.78, 0.86, P: 0.001, I2: 4.5%), CSS rate (HR: 0.72, 95% CI: 0.63, 0.81, P: 0.011, I2 = 0%), and RFS rate (HR: 719, 95% CI: 0.524, 0.986, P: 0.001) and decreased the recurrence rate after gastrectomy (HR: 0.83, 95% CI: 0.77, 0.87, P: 0.001, I2: 0%). The use of metformin was significantly associated with a greater increase in OS and CSS rate and a greater decrease in recurrence rate in the Asian population than in the Western population.The use of metformin in diabetic patients with GC can be associated with improved OS, CSS, RFS, and reduced recurrence rate after gastrectomy, especially in the Asian population.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.