Retrospective analysis of the influence of 25-hydroxyvitamin D on disease progression and survival in pancreatic cancer

Abstract

BackgroundVitamin D deficiency is implicated in neoplastic processes in multiple organs, including the pancreas. While animal and human data have established a relationship between serum vitamin D (25(OH)D) and the development of pancreatic cancer, few studies have examined the effects of 25(OH)D on time to progression (TTP) and overall survival (OS) in this patient population. We hypothesize that lower baseline serum concentrations (BSC) of 25(OH)D will be associated with decreased TTP and OS.MethodsThis retrospective analysis of 1222 patients with pancreatic cancer aims to identify potential relationships between 25(OH)D and both TTP and OS, while controlling for the effects of ethnicity and body mass index (BMI). Baseline 25(OH)D was divided into quartiles defined as deficient (<20 ng/mL), insufficient (20–39 ng/mL), sufficient (40–59 ng/mL), and optimal (≥60 ng/ml). Statistical significance was declared if the two-sided p-value was ≤ 0.05.ResultsFor the 627 subjects included for analysis, the median 25(OH)D was 27 ng/mL (range 4 to 114), 30.0 % were 25(OH)D deficient (<20 ng/mL), and 47.2 % were insufficient (20–39 ng/mL). Ethnicity (p < 0.0001) and BMI (p = 0.05) were significantly associated with (BSC)of 25(OH)D, while TTP (p = 0.39) and OS (p = 0.37) were not associated.ConclusionSuboptimal vitamin D levels (<60 ng/mL) occurred in 96 % of patients analyzed. Both ethnicity and BMI were statistically significantly associated with vitamin D deficiency and insufficiency. Similar to results previously reported in the literature, this analysis did not identify a significant association between BSC of 25(OH)D and OS or TTP in patients with pancreatic cancer.

Plasma 25-hydroxyvitamin D levels, vitamin D intake, and pancreatic cancer risk or mortality: a meta-analysis

“…Five studies on pancreatic cancer mortality in relation to plasma 25(OH)D levels were published between 2013 and 2016, and involved a total of 1613 patients [ 19 , 21 , 22 , 25 , 28 ] (Table 1 ). Of these five studies, four were conducted in the United States and one in Germany.…”

“…Five studies assessed the association between plasma 25(OH)D levels and pancreatic cancer mortality [ 19 , 21 , 22 , 25 , 28 ]. Our results indicated that the high versus the low plasma 25(OH)D levels was significantly associated with reduced pancreatic cancer mortality without significant heterogeneity (HR=0.81, 95% CI=0.68–0.96, I 2 =43.0%; Figure 2 ), and the result of Begg's and Egger's tests showed no evidence of publication bias ( P Begg's = 1.00, P Egger's = 0.80, Figure 3 ).…”

“…Moreover, we performed a subgroup analysis including only advanced disease, and the result indicated that high plasma 25(OH)D levels tended toward a favorable survival for locally advanced or metastatic disease, although statistical significance was not reached (HR=0.76, 95% CI=0.55–1.04, I 2 =51.4%). Of those five studies, only two studies provided the HR on progression-free survival (PFS) [ 22 , 25 ], and the pooled HR indicated no association between plasma 25(OH)D levels and PFS for pancreatic cancer (HR=1.06, 95% CI=0.84–1.33, I 2 =12.9%).…”

Pancreas Cancer-Associated Weight Loss

“…After resection, reported nutritional deficiencies include fat‐soluble vitamins A, D, and E, vitamins B12 and B6, iron, zinc, selenium, biotin, and copper. None of these can be considered diagnostic of malnutrition; however, vitamin D deficiency has been reported in patients with PC and may contribute to poor outcomes . These findings were concluded from retrospective analysis, and it is not clear whether vitamin D supplementation improves outcomes.…”

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

“…An increased risk for pancreatic cancer with higher vitamin D levels has been found among heavy smokers 77 . Survivorship has been examined, as a retrospective study completed by McGovern and colleagues did not find any association between vitamin D concentrations and disease progression or survival in patients with pancreatic cancer between the highest and lowest quintiles (<20 and >60 ng/mL) 78 . No studies have been completed examining the role of supplementation and pancreatic cancer risk or outcomes once diagnosed.…”