Longitudinal, observational study on associations between postoperative nutritional vitamin D supplementation and clinical outcomes in esophageal cancer patients undergoing esophagectomy

Abstract

Vitamin D can exert anticancer effect beyond bone and calcium metabolism. We aimed to investigate whether postoperative vitamin D supplementation affects quality of life (QOL) and survival in esophageal cancer (EC) patients. We utilized the widely used EORTC QLQ-C30 and QLQ-OES18 to assess QOL at EC diagnosis and 24 months after surgery. Generalized estimating equations (GEEs) were used to analysis the association of vitamin D supplement use with QOL. Kaplan-Meier method and Cox regression model were used to evaluate the prognostic value of vitamin D supplementation. The notably improved QOL were found among vitamin D supplementation users compared with non-users (p < 0.05). Kaplan-Meier analysis revealed that vitamin D supplement use was significantly associated with improved disease-free survival (DFS) (p = 0.030), but not related to overall survival (OS) (p = 0.303). The multivariable analysis further demonstrated vitamin D supplement use as an independent prognostic factor for DFS (p = 0.040; HR 0.610; 95% CI 0.381–0.978). In conclusion, these results showed that vitamin D supplement use could serve as a promising intervention to enhancing QOL and prolonging DFS in EC.

Dietary Supplements Commonly Used by Cancer Survivors: Are There Any Benefits?

“…In patients with Barrett's esophagus, no association was found between circulating 25(OH)D levels and incidence of esophageal adenocarcinoma despite a high prevalence of vitamin D deficiency (23.6%) or insufficiency (34.7%) 81 . However, in another study, patients receiving vitamin D supplements postoperatively for esophageal cancer had a longer disease‐free period, although there was no difference in overall survival 82 …”

Integrative medicine in cancer survivors

“…In an observational study of postoperative esophageal cancer patients, 49 patients who took 200–400 IU daily over one year were compared to 254 non-users. Better quality of life and disease-free survival were detected in the vitamin D group, but there was no significant difference in overall survival identified [32]. Different distributions of confounders between the groups make these data inconclusive but intriguing.…”

Vitamin D receptor as a marker of prognosis in oesophageal adenocarcinoma: a prospective cohort study

“…One observational study has investigated the impact of post-operative vitamin D supplementation in patients having undergone surgical resection for their oesophageal squamous cell carcinoma [ 26 ]. There were 280 patients with oesophageal squamous cell carcinoma and of these there were 49 patients who took daily vitamin D supplements of between 200–400 international units daily [ 26 ].…”

“…One observational study has investigated the impact of post-operative vitamin D supplementation in patients having undergone surgical resection for their oesophageal squamous cell carcinoma [ 26 ]. There were 280 patients with oesophageal squamous cell carcinoma and of these there were 49 patients who took daily vitamin D supplements of between 200–400 international units daily [ 26 ]. Although vitamin D supplement use was not associated with improved overall survival, it was associated with a 39% reduction in disease recurrence in adjusted analysis (HR 0.61 95% CI 0.38–0.98) [ 26 ].…”

“…There were 280 patients with oesophageal squamous cell carcinoma and of these there were 49 patients who took daily vitamin D supplements of between 200–400 international units daily [ 26 ]. Although vitamin D supplement use was not associated with improved overall survival, it was associated with a 39% reduction in disease recurrence in adjusted analysis (HR 0.61 95% CI 0.38–0.98) [ 26 ]. This demonstrates the role that vitamin D may play in the post-operative phase in oesophageal squamous cell carcinoma.…”