Vitamin D status in patients with stage IV colorectal cancer: findings from Intergroup trial N9741.

Abstract

PURPOSE:

Previous studies have suggested that higher plasma 25-hydroxyvitamin D(3) [25(OH)D] levels are associated with decreased colorectal cancer risk and improved survival, but the prevalence of vitamin D deficiency in advanced colorectal cancer and its influence on outcomes are unknown.

PATIENTS AND METHODS:

We prospectively measured plasma 25(OH)D levels in 515 patients with stage IV colorectal cancer participating in a randomized trial of chemotherapy. Vitamin D deficiency was defined as 25(OH)D lower than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as ≥ 30 ng/mL. We examined the association between baseline 25(OH)D level and selected patient characteristics. Cox proportional hazards models were used to calculate hazard ratios (HR) for death, disease progression, and tumor response, adjusted for prognostic factors.

RESULTS:

Among 515 eligible patients, 50% of the study population was vitamin D deficient, and 82% were vitamin D insufficient. Plasma 25(OH)D levels were lower in black patients compared to white patients and patients of other race (median, 10.7 v 21.1 v 19.3 ng/mL, respectively; P < .001), and females compared to males (median, 18.3 v 21.7 ng/mL, respectively; P = .0005). Baseline plasma 25(OH)D levels were not associated with patient outcome, although given the distribution of plasma levels in this cohort, statistical power for survival analyses were limited.

CONCLUSION:

Vitamin D deficiency is highly prevalent among patients with stage IV colorectal cancer receiving first-line chemotherapy, particularly in black and female patients.

• Authors: Kimmie Ng, Daniel J Sargent, Richard M Goldberg, Jeffrey A Meyerhardt, Erin M Green, Henry C Pitot, Bruce W Hollis, Michael N Pollak, Charles S Fuchs
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 29 Issue 12 Pg. 1599-606 (Apr 20 2011) ISSN: 1527-7755 [Electronic] United States
• PMID: 21422438 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Vitamin D
• 25-hydroxyvitamin D

Topics

• Adenocarcinoma (blood, drug therapy, mortality, pathology)
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers (blood)
• Canada
• Colorectal Neoplasms (blood, drug therapy, mortality, pathology)
• Disease Progression
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Neoplasm Staging
• Prevalence
• Proportional Hazards Models
• Prospective Studies
• Puerto Rico
• Risk Assessment
• Risk Factors
• Time Factors
• Treatment Outcome
• United States
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (blood, mortality)