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Higher vitamin D levels linked with better colorectal cancer outcomes
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High postoperative plasma vitamin D levels were associated with improved survival outcomes in patients with stage I to III colorectal cancer, according to recent study data.
To investigate the association between 25-hydroxyvitamin D (25-[OH]D) and survival, researchers from the United Kingdom and Ireland performed a prospective study of 1,598 patients with stage I to III colorectal cancer (CRC) who underwent surgical resection. They analyzed patient factors with established links to CRC mortality or etiology, and postoperatively tested for interactions with total 25-(OH)D plasma levels (reflecting both dietary and skin-synthesized vitamin D) and polymorphic variation at the vitamin D receptor (VDR) gene locus. Median time to sampling was 105 days after surgery.
Higher 25-(OH)D levels were associated with lower CRC-specific mortality (P=.008) and overall mortality (P=.003). Comparing highest vs. lowest 25-(OH)D tertiles, adjusted HRs were 0.68 (95% CI, 0.5-0.9) for CRC-specific mortality and 0.7 (95% CI, 0.55-0.89) for overall mortality. The adjusted HR for stage II CRC-specific mortality was 0.44 (95% CI, 0.25-0.76). Higher 25-(OH)D levels were more protective for stage II and III patients not undergoing chemotherapy compared with those who did (lowest vs. highest tertiles; HR=0.42; 95% CI, 0.22-0.8), with the most prominent effect in stage II patients (HR=0.34; 95% CI, 0.14-0.81). Gene-environment interactions were detected between 25-(OH)D levels and rs11568820 genotype (P=.008) and number of protective alleles (P=.004) for CRC-specific mortality, and GAGC haplotype at the VDR locus for overall mortality (P=.008).
“Higher plasma 25-(OH)D level is associated with lower cancer-specific and all-cause mortality,” the researchers concluded. “The interaction between 25-(OH)D and genetic VDR locus in relation to survival provides additional evidence implicating the vitamin D pathway and provides support for a causal relationship.”
Disclosure: The researchers report no relevant financial disclosures.
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