What to tell melanoma patients about Vitamin D

August 9, 2016

Study Abstract

Purpose 
To evaluate for an association between 25-hydroxyvitamin D levels (vitamin D) and outcome measures in patients with melanoma after evaluation is controlled for systemic inflammatory response (SIR) on the basis of simultaneous C-reactive protein (CRP) measurement.

Materials and Methods
Plasma samples from 1,042 prospectively observed patients with melanoma were assayed for vitamin D and CRP. The associations of demographics and CRP with vitamin D were determined, followed by a determination of the association between vitamin D and stage and outcome measures from the date of blood draw. The vitamin D level was considered sufficient if it was 30 to 100 ng/mL. Kaplan-Meier and Cox regression analyses were performed.

Results 
The median vitamin D level was 25.0 ng/mL. The median follow-up time was 7.1 years. A lower vitamin D was associated with the blood draw during fall/winter months (P < .001), older age (P = .001), increased CRP (P < .001), increased tumor thickness (P < .001), ulcerated tumor (P = .0105), and advanced melanoma stage (P= .0024). On univariate analysis, lower vitamin D was associated with poorer overall (OS; P < .001), melanoma-specific survival (MSS; P = .0025), and disease-free survival (DFS; P = .0466). The effect of vitamin D on these outcome measures persisted after adjustment for CRP and other covariates. Multivariable hazards ratios per unit decrease of vitamin D were 1.02 for OS (95% CI, 1.01 to 1.04; P = .0051), 1.02 for MSS (95% CI, 1.00 to 1.04; P = .048), and 1.02 for DFS (95% CI, 1.00 to 1.04; P = .0427).

Conclusion 
Lower vitamin D levels in patients with melanoma were associated with poorer outcomes. Although lower vitamin D was strongly associated with higher CRP, the associations of lower vitamin D with poorer OS, MSS, and DFS were independent of this association. Investigation of mechanisms responsible for these associations may be of value to patients with melanoma.

Source:

Fang, S, et al.  Association of Vitamin D Levels With Outcome in Patients With Melanoma After Adjustment For C-Reactive Protein.  Published online before print March 21, 2016, doi:10.1200/JCO.2015.64.1357JCO May 20, 2016 vol. 34 no. 151741-1747 http://jco.ascopubs.org/conten...

See also:

Sondak, VK, et al. Vitamin D and Melanoma: What Do We Tell Our Patients?  Editorial published online before print April 4, 2016, doi:10.1200/JCO.2016.66.5240JCO April 4, 2016 JCO665240 http://jco.ascopubs.org/conten...

ASCO Reading Room Expert Critique: What to Tell Melanoma Patients about Vitamin D – Some rationale for monitoring blood levels of the vitamin, with follow-up supplementation as needed http://www.medpagetoday.com/re...



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