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. 2019 Aug;28(8):1379-1387.
doi: 10.1158/1055-9965.EPI-18-1190. Epub 2019 Jun 11.

Serum Levels of 25-Hydroxyvitamin D at Diagnosis Are Not Associated with Overall Survival in Esophageal Adenocarcinoma

Elizabeth Loehrer  1 , Rebecca A Betensky  2 , Edward Giovannucci  3   4 , Li Su  5 , Andrea Shafer  5   6 , Bruce W Hollis  7 , David C Christiani  5   3   6
Affiliations

Serum Levels of 25-Hydroxyvitamin D at Diagnosis Are Not Associated with Overall Survival in Esophageal Adenocarcinoma

Elizabeth Loehrer et al. Cancer Epidemiol Biomarkers Prev. 2019 Aug.

Abstract

Background: Higher levels of circulating 25-hydroxyvitamin D [25(OH)D] are associated with longer survival in several cancers, but the results have differed across cancer sites. The association between serum 25(OH)D levels and overall survival (OS) time in esophageal adenocarcinoma remains unclear.

Methods: We utilized serum samples from 476 patients with primary esophageal adenocarcinoma, recruited from Massachusetts General Hospital (Boston, MA) between 1999 and 2015. We used log-rank tests to test the difference in survival curves across quartiles of 25(OH)D levels and extended Cox modeling to estimate adjusted HRs. We tested for interactions between clinical stage or BMI on the association between 25(OH)D and OS. We additionally performed sensitivity analyses to determine whether race or timing of blood draw (relative to treatment) affected these results.

Results: We found no evidence that survival differed across quartiles of 25(OH)D (log rank P = 0.48). Adjusting for confounders, we found no evidence that the hazard of death among the highest quartile of 25(OH)D (quartile 1) differed from any other quartile [quartile 2 HR = 0.90, 95% confidence interval (CI), 0.67-1.23; quartile 3 HR = 1.03, 95% CI, 0.76-1.38; quartile 4 (lowest) HR = 0.98, 95% CI, 0.72-1.33]. Sensitivity analyses yielded consistent results when accounting for race or time between diagnosis and blood draw. Moreover, we did not find evidence of interaction between 25(OH)D and clinical stage or BMI on OS.

Conclusions: Serum level of 25(OH)D near time of diagnosis was not associated with OS in patients with esophageal adenocarcinoma.

Impact: Screening 25(OH)D levels among patients with esophageal adenocarcinoma at diagnosis is not clinically relevant to their cancer prognosis based on present evidence.

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Conflict of interest statement

Conflict of Interest: The authors have no conflict of interests to report

Figures

Figure 1:
Figure 1:. Flow chart of the study population:
Figure 1 shows a flow chart of patients included in the study and patients who were excluded from analysis.
Figure 2:
Figure 2:. Kaplan-Meier survival curve by quartiles of 25(OH)D accounting for month of blood draw
Figure 2 shows the Kaplan-Meier survival curve, and corresponding Logrank test, of overall surival among esophageal adenocarcinoma patients stratified by quartiles of serum 25(OH)D levels, categorized accounting for month of blood draw. Quartile 1 represents the highest 25(OH)D levels, and quartile 4 includes the lowest 25(OH)D levels.
See this image and copyright information in PMC

References

    1. Rubenstein JH, Shaheen NJ. Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma. Gastroenterology 2015;149(2):302–17 e1 doi 10.1053/j.gastro.2015.04.053. - DOI - PMC - PubMed
    1. Zhang Y Epidemiology of esophageal cancer. World J Gastroenterol 2013;19(34):5598–606 doi 10.3748/wjg.v19.i34.5598. - DOI - PMC - PubMed
    1. Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 1991;265(10):1287–9. - PubMed
    1. Cook MB, Chow WH, Devesa SS. Oesophageal cancer incidence in the United States by race, sex, and histologic type, 1977–2005. Br J Cancer 2009;101(5):855–9 doi 10.1038/sj.bjc.6605246. - DOI - PMC - PubMed
    1. Brown LM, Devesa SS, Chow WH. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst 2008;100(16):1184–7 doi 10.1093/jnci/djn211. - DOI - PMC - PubMed

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