Saturday, December 13, 2014

Vitamin D and Melanoma


Vitamin D level at diagnosis and its variation during follow up as prognostic factor of cutaneous melanoma.  Saiag, Aegerter, Vitous, et al.  June 2014 ASCO.

Low 25-hydroxyvitamin D3 serum concentration at diagnosis of melanoma might be associated with worse survival.   Patients were collected from Paris hospitals from 2003 -2008 as they were diagnosed with Stage I-IV melanoma and were followed until June 2011.  1,171 patients were included, with 411 relapses during f/u, and 303 deaths.  Median serum Vit D levels at inclusion were inversely correlated with prognostic factors such as AJCC stage, Breslow's thickness and ulceration, but were not associated with disease free survival.  Changes in Vit D levels during follow-up were significantly associated with worse disease free survival.  We show that Vit D variation during follow-up is an independent melanoma prognostic marker, but not its level at diagnosis.  Previously reported association between low Vit D level at diagnosis and poor prognosis were probably due to insufficient adjustment for prognostic factors.

I'm not sure what these peeps are saying in their last sentence.  That seems an odd conclusion for them to draw.  By their own admission, folks with lower levels of Vit D had increased Breslow thickness and ulceration.  So...we can't KNOW that the decreased Vit D levels CAUSED that...but....  And, we can't KNOW whether low Vit D or those known risk factors for worse prognosis (increased thickness and ulceration) did in fact, create the poor prognosis that did materialize....but....???

Low Serum 25-Hydroxyvitamin D Concentrations are Associated with Increased Risk for Melanoma and unfavorable Prognosis.  Bade, Zdebik, Wagenpfeil, et al.  PLoS One.  Dec 2014.

Low vitamin D status (Serum 25(OH)D concentration is associated with increased incidence and unfavorable outcome of various types of cancer.  Serum Vit D concentrations were retrospectively analyzed in 324 melanoma patients and 141 healthy controls.  Vit D levels were significantly lower in melanoma patients (med = 13.6 ng/ml) vs controls (med = 15.6 ng/ml).  When looking at Vit D levels in the melanoma patients:  those with lower levels of Vit D had greater Breslow thickness and inferior survival (med = 80 months) vs the melanoma patients with higher levels (med = 195 months).  Our data support that concept that serum Vit D concentrations are associated with risk and prognosis of melanoma.  Whether normalizing serum Vit D in these patients improves outcomes will require testing in future clinical trials.

This report is at least consistent within its own data.  Clearly, there is much related to Vit D and its effects on cancer that we don't understand.

For what it's worth! - c

No comments:

Post a Comment