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Home All Specialties Gastroenterology

High post-surgery vitamin D levels linked with increased survival in colon cancer

byKhang DinhandMarc Succi, MD
July 13, 2014
in Gastroenterology, Oncology, Surgery
Reading Time: 3 mins read
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1. In patients with Stage I-III colorectal cancer, higher postoperative serum 25-hydroxy vitamin D levels were associated with decreased cancer-specific mortality as well as overall mortality. 

2. There were significant interactions between serum vitamin D levels and polymorphisms in the vitamin D receptor gene that were associated with overall survival, which may indicate a causal relationship between vitamin D level and survival. 

Evidence Rating: 2 (Good)

Study Rundown: Pre-treatment levels of serum vitamin D have been previously linked to survival in colorectal cancer (CRC).  However, because vitamin D is a hormone involved in a wide variety of physiologic processes, establishing a causal inference is difficult.  In this study, the authors prospectively assessed the post-operative serum levels of vitamin D in Scottish patients with stage I to III CRC.  The authors also performed a meta-analysis of their data along with four prior studies examining serum vitamin D levels and CRC survival.  They found that there was a significant benefit in both CRC-specific and overall survival for patients with higher serum vitamin D levels as compared to those with lower levels.  In order to strengthen a causal relationship, the study also addressed reverse causation, an important confounder, by testing for interactions between serum vitamin D levels and polymorphisms at the vitamin D receptor (VDR) locus.  While there were no associations between survival and individual VDR SNPs, overall survival was significantly associated with interactions between vitamin D levels and VDR SNPs.  This study was limited in the fact that serum vitamin D levels were sampled only once, and moreover, at times varying from 53 to 200 days postoperatively.

Click to read the study in The Journal of Clinical Oncology

Relevant reading: The epidemiology of vitamin D and cancer incidence and mortality: A review (United States)

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In-Depth [prospective case-control and  meta-analysis]:  In this prospective, population-based case-control study from the Scottish Managed Clinical Networks, 1598 patients who had stage I to III CRC were followed for a median of 8.9 years.  Patients were treated with curative surgery and chemotherapy.  546 patients had 25 hydroxy vitamin D levels less than 7.25 ng/mL, 528 patients had levels between 7.25 and 13.25 ng/mL, and 524 had levels greater than 13.25 ng/mL.  These groups were matched for factors known to influence CRC survival such as age, sex, and smoking status.  Serum vitamin D levels were measured postoperatively, ranging from 53 to 200 days, and were May-adjusted to correct for seasonal variations.  Patients with the highest vitamin D levels had a CRC-specific mortality HR of 0.68 (95% CI: 0.50-0.90) and an overall mortality HR of 0.70 (95% CI: 0.55-0.89) compared to those with the lowest levels.  In a meta-analysis of the present study’s data along with four previous studies, the adjusted HR for CRC-specific mortality was 0.67 (95% CI: 0.54-0.81) and 0.65 (95% CI: 0.55-0.77) for overall mortality.  A genetic haplotype analysis showed that the interaction between the GAGC haplotype and vitamin D level was significantly associated with overall survival (p=0.008).

More from this author: Erlotinib does not demonstrate increased survival in ovarian epithelial carcinomas, Afatinib shows increased progression-free survival in non-small-cell lung cancer, Radiosurgery alone may be effective for some arteriovenous malformations, Escalated-dose radiotherapy did not increase survival in prostate cancer, Stereotactic radiosurgery promising for patients with multiple brain metastases

Image: PD

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.  

Tags: colon cancervitamin d
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