Higher Post-Operative Serum Vitamin D Level is Associated with Better Survival Outcome in Colorectal Cancer Patients

Markotić, Antonio; Langer, Sanja; Kelava, Tomislav; Vučić, Katarina; Turčić, Petra; Tokić, Tomislav; Štefančić, Ljilja; Radetić, Eva; Farrington, Susan M.; Timofeeva, Maria; Rudan, Igor; Campbell, Harry; Dunlop, Malcolm G.; Kirac, Iva; Zgaga, Lina

doi:10.1080/01635581.2019.1597135

Cited by 21 publications

(26 citation statements)

References 36 publications

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“…A total of 18 prospective cohort studies were included in the meta-analysis of OS (5579 events and 17,770 participants) [ 18 , 27 , 35–49 ], and 10 of them showed the outcome of CSS (2411 events and 9128 participants) [ 18 , 35 , 36 , 39–42 , 45 , 46 ]. Nine studies were conducted in the Europe [ 18 , 39 , 40 , 42 , 44–46 , 48 ], six were performed in US [ 35 , 36 , 38 , 41 , 43 , 49 ], and the remaining studies were executed in Asia [ 37 , 47 ] and Australia [ 27 ]. The sample size of the included studies ranged from 52 to 3818 participants.…”

Section: Resultsmentioning

confidence: 99%

“…The sample size of the included studies ranged from 52 to 3818 participants. Five studies investigated stage I-III patients [ 18 , 42 , 47 , 48 ], nine studies investigated stage I-IV patients [ 27 , 35–37 , 39–41 , 45 , 46 ] and four studies investigated exclusively stage IV patients [ 38 , 43 , 44 , 49 ]. The level of covariate adjustment in the individual studies differed, but most studies adjusted for age, sex, and some indicators relating to tumor spreading.…”

Section: Resultsmentioning

confidence: 99%

“…The level of covariate adjustment in the individual studies differed, but most studies adjusted for age, sex, and some indicators relating to tumor spreading. Three studies employed no, or only very limited, adjustment for covariates [ 42 , 43 , 48 ]. On the basis of the Newcastle–Ottawa scale criteria, 10 articles were classified as high-quality [ 18 , 27 , 35 , 36 , 38 , 39 , 41 , 45 , 46 , 49 ], and the remaining studies were classified as moderate-quality [ 37 , 40 , 42–44 , 47 , 48 ].…”

Section: Resultsmentioning

confidence: 99%

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Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose–response meta-analysis

Wu¹,

Xue

Zhao³

et al. 2020

Bioscience Reports

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Epidemiological studies have suggested inconclusive associations between 25-hydroxyvitamin D (25(OH)D) and survival in patients with colorectal cancer (CRC). The aim of this study was to quantitatively assess these associations. PubMed, EMBASE and Web of Science databases were systematically searched for eligible studies. Subgroup analyses based on study geographic location, publication year, length of follow-up time, sample size, and stage were conducted to explore potential sources of heterogeneity. Dose-response relationships and pooled hazard ratios (HR) for overall and CRC-specific survival comparing the highest versus the lowest categories of circulating 25(OH)D concentrations were assessed. Overall, 17 original studies with a total of 17770 CRC patients were included. Pooled HR (95% confidence intervals) comparing highest versus lowest categories were 0.64 (0.55-0.72) and 0.65 (0.56-0.73) for overall and CRC-specific survival, respectively. Studies conducted in the USA, with median follow-up time ≥ 8 years, larger sample size, and including stage I-III patients showed a more prominent association between 25(OH)D concentrations and overall survival. The dose-response analysis showed that the risk of all-cause mortality was reduced by 7% (HR = 0.93; 95% CI: 0.90, 0.95), and the risk of CRC-specific mortality was reduced by 12% (HR = 0.88; 95% CI: 0.84, 0.93) for each 20 nmol/L increment of 25(OH)D concentration. This meta-analysis provides evidences that a higher 25(OH)D concentration is associated with lower overall mortality and CRC-specific mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose–response meta-analysis

Wu¹,

Xue

Zhao³

et al. 2020

Bioscience Reports

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“…In patients with advanced or metastatic colorectal cancer, higher 25(OH)D circulating levels were significantly associated with higher overall survival and progression-free survival (p trend = 0.0009 and 0.03), respectively [6] and higher 25(OH)D circulating levels in postoperative phase were associated with a better prognosis (HR: 0.53; 95% CI: 0.33 to 0.84, p = 0.006/HR: 0.91; 95% CI: 0.84 to 0.99, p = 0.027) [60,61]. Conversely, low levels of 25(OH)D observed in colorectal cancer patients in preoperative phase were correlated to increased systemic inflammation markers such as C reactive protein (p = 0.0021), but not to prognosis [72].…”

Section: Vitamin D and Cancer: Epidemiological Evidencementioning

confidence: 98%

“…Several observational studies have shown that circulating levels of 25(OH)D, used as surrogate marker for the evaluation of vitamin D status, may be associated with cancer risk [5,6,[56][57][58][59] and prognosis [6,[60][61][62][63][64][65]. A strong association between low 25(OH)D circulating levels and colorectal [6,56,60,61,[66][67][68][69][70][71][72], prostate [59,62,63,[73][74][75][76][77][78][79] and breast [52,58,[80][81][82][83][84][85][86][87][88][89][90][91][92][93]...…”

Section: Vitamin D and Cancer: Epidemiological Evidencementioning

confidence: 99%

Vitamin D-Induced Molecular Mechanisms to Potentiate Cancer Therapy and to Reverse Drug-Resistance in Cancer Cells

et al. 2020

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Increasing interest in studying the role of vitamin D in cancer has been provided by the scientific literature during the last years, although mixed results have been reported. Vitamin D deficiency has been largely associated with various types of solid and non-solid human cancers, and the almost ubiquitous expression of vitamin D receptor (VDR) has always led to suppose a crucial role of vitamin D in cancer. However, the association between vitamin D levels and the risk of solid cancers, such as colorectal, prostate and breast cancer, shows several conflicting results that raise questions about the use of vitamin D supplements in cancer patients. Moreover, studies on vitamin D supplementation do not always show improvements in tumor progression and mortality risk, particularly for prostate and breast cancer. Conversely, several molecular studies are in agreement about the role of vitamin D in inhibiting tumor cell proliferation, growth and invasiveness, cell cycle arrest and inflammatory signaling, through which vitamin D may also regulate cancer microenvironment through the activation of different molecular pathways. More recently, a role in the regulation of cancer stem cells proliferation and short non-coding microRNA (miRNAs) expression has emerged, conferring to vitamin D a more crucial role in cancer development and progression. Interestingly, it has been shown that vitamin D is able not only to potentiate the effects of traditional cancer therapy but can even contribute to overcome the molecular mechanisms of drug resistance—often triggering tumor-spreading. At this regard, vitamin D can act at various levels through the regulation of growth of cancer stem cells and the epithelial–mesenchymal transition (EMT), as well as through the modulation of miRNA gene expression. The current review reconsiders epidemiological and molecular literature concerning the role of vitamin D in cancer risk and tumor development and progression, as well as the action of vitamin D supplementation in potentiating the effects of drug therapy and overcoming the mechanisms of resistance often triggered during cancer therapies, by critically addressing strengths and weaknesses of available data from 2010 to 2020.

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Post‐diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

Chan,

Cariolou,

Markozannes

et al. 2024

Intl Journal of Cancer

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The role of diet in colorectal cancer prognosis is not well understood and specific lifestyle recommendations are lacking. We searched for randomised controlled trials (RCTs) and longitudinal observational studies on post‐diagnosis dietary factors, supplement use and colorectal cancer survival outcomes in PubMed and Embase from inception until 28th February 2022. Random‐effects dose–response meta‐analyses were conducted when at least three studies had sufficient information. The evidence was interpreted and graded by the CUP Global independent Expert Committee on Cancer Survivorship and Expert Panel. Five RCTs and 35 observational studies were included (30,242 cases, over 8700 all‐cause and 2100 colorectal cancer deaths, 3700 progression, recurrence, or disease‐free events). Meta‐analyses, including 3–10 observational studies each, were conducted for: whole grains, nuts/peanuts, red and processed meat, dairy products, sugary drinks, artificially sweetened beverages, coffee, alcohol, dietary glycaemic load/index, insulin load/index, marine omega‐3 polyunsaturated fatty acids, supplemental calcium, circulating 25‐hydroxyvitamin D (25[OH]D) and all‐cause mortality; for alcohol, supplemental calcium, circulating 25(OH)D and colorectal cancer‐specific mortality; and for circulating 25(OH)D and recurrence/disease‐free survival. The overall evidence was graded as ‘limited’. The inverse associations between healthy dietary and/or lifestyle patterns (including diets that comprised plant‐based foods), whole grains, total, caffeinated, or decaffeinated coffee and all‐cause mortality and the positive associations between unhealthy dietary patterns, sugary drinks and all‐cause mortality provided ‘limited—suggestive’ evidence. All other exposure‐outcome associations provided ‘limited—no conclusion’ evidence. Additional, well‐conducted cohort studies and carefully designed RCTs are needed to develop specific lifestyle recommendations for colorectal cancer survivors.

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Higher Post-Operative Serum Vitamin D Level is Associated with Better Survival Outcome in Colorectal Cancer Patients

Cited by 21 publications

References 36 publications

Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose–response meta-analysis

Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose–response meta-analysis

Vitamin D-Induced Molecular Mechanisms to Potentiate Cancer Therapy and to Reverse Drug-Resistance in Cancer Cells

Post‐diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

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