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. 2009 Nov 10;27(32):5439-44.
doi: 10.1200/JCO.2009.22.1135. Epub 2009 Sep 21.

Serum 25-hydroxyvitamin D3 levels are associated with breslow thickness at presentation and survival from melanoma

Julia A Newton-Bishop  1 , Samantha Beswick, Juliette Randerson-Moor, Yu-Mei Chang, Paul Affleck, Faye Elliott, May Chan, Susan Leake, Birute Karpavicius, Sue Haynes, Kairen Kukalizch, Linda Whitaker, Sharon Jackson, Edwina Gerry, Clarissa Nolan, Chandra Bertram, Jerry Marsden, David E Elder, Jennifer H Barrett, D Timothy Bishop
Affiliations

Serum 25-hydroxyvitamin D3 levels are associated with breslow thickness at presentation and survival from melanoma

Julia A Newton-Bishop et al. J Clin Oncol. .

Abstract

Purpose: A cohort study was carried out to test the hypothesis that higher vitamin D levels reduce the risk of relapse from melanoma.

Methods: A pilot retrospective study of 271 patients with melanoma suggested that vitamin D may protect against recurrence of melanoma. We tested these findings in a survival analysis in a cohort of 872 patients recruited to the Leeds Melanoma Cohort (median follow-up, 4.7 years).

Results: In the retrospective study, self-reports of taking vitamin D supplements were nonsignificantly correlated with a reduced risk of melanoma relapse (odds ratio = 0.6; 95% CI, 0.4 to 1.1; P = .09). Nonrelapsers had higher mean 25-hydroxyvitamin D(3) levels than relapsers (49 v 46 nmol/L; P = .3; not statistically significant). In the cohort (prospective) study, higher 25-hydroxyvitamin D(3) levels were associated with lower Breslow thickness at diagnosis (P = .002) and were independently protective of relapse and death: the hazard ratio for relapse-free survival (RFS) was 0.79 (95% CI, 0.64 to 0.96; P = .01) for a 20 nmol/L increase in serum level. There was evidence of interaction between the vitamin D receptor (VDR) BsmI genotype and serum 25-hydroxyvitamin D(3) levels on RFS.

Conclusion: Results from the retrospective study were consistent with a role for vitamin D in melanoma outcome. The cohort study tests this hypothesis, providing evidence that higher 25-hydroxyvitamin D(3) levels, at diagnosis, are associated with both thinner tumors and better survival from melanoma, independent of Breslow thickness. Patients with melanoma, and those at high risk of melanoma, should seek to ensure vitamin D sufficiency. Additional studies are needed to establish optimal serum levels for patients with melanoma.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Variation in serum vitamin D levels by season of venipuncture in the prospective cohort study cases (number of patients in parentheses). A conservative optimal level of 60 nmol/L is indicated by the gray line, and a higher optimal level based on stabilization of parathyroid hormone levels at 75 to 90 nmol/L is indicated by the red line.
Fig 2.
Fig 2.
Kaplan-Meier curves of different serum vitamin D levels at interview (categorized based on tertile cutoff points) on relapse-free survival from melanoma in the cohort study.
See this image and copyright information in PMC

Comment in

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