Prognostic value of 25-hydroxyvitamin D3 levels at diagnosis and during follow-up in melanoma patients

Philippe Saiag, Philippe Aegerter, Dominique Vitoux, Celeste Lebbé, Pierre Wolkenstein, Nicolas Dupin, Vincent Descamps, Selim Aractingi, Elisa Funck-Brentano, Philippe Autier, Miruna Dragomir, Mathieu Boniol

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

A low 25-hydroxyvitamin D3 (25(OH)D3) serum concentration at melanoma diagnosis might be associated with worse survival. We prospectively studied the prognostic value of 25(OH)D3 at diagnosis and during follow-up. MelanCohort is a cohort of invasive melanoma patients. Serum 25(OH)D3 was measured by mass spectrometry and standardized on month of blood drawn, age, sex, and body mass index (BMI). Role of 25(OH)D3 levels and risk of relapse was analyzed in a Cox proportional hazards model adjusting for age, sex, BMI, and American Joint Committee on Cancer (AJCC) stage. All statistical tests were two-sided. One thousand one hundred seventy-one patients were included. 25(OH)D3 levels at diagnosis (median = 49.0 nmol/L) were inversely correlated with prognostic factors such as AJCC stage (P < .001 Kruskal-Wallis), Breslow's thickness (P < .001 Spearman correlation), and ulceration (P < .001 Kruskal-Wallis), but not with risk of relapse. Changes in 25(OH)D3 levels during follow-up were associated with worse prognosis: With a third quartile Q3 of average change per year (-0.30 to 4.60 nmol/L/Y) used as reference, hazard ratios for the first, second, and fourth quarters were 1.94 (95% confidence interval [CI] = 1.36 to 2.76), 1.23 (95% CI = 0.85 to 1.78), and 1.61 (95% CI = 1.14 to 2.28), respectively. In sensitivity analyses, no changes were observed either by AJCC stage, number of 25(OH)D3 measures performed, or by 25(OH)D3 level at baseline. No evidence of reverse causation was identified. Analyses performed on overall survival yielded similar results. We show that 25(OH)D3 variation during follow-up is an independent melanoma prognostic marker, but not its level at diagnosis. Previously reported associations between low 25(OH)D3 level at diagnosis and poor prognosis seem to be due to insufficient adjustment for prognostic factors.
LanguageEnglish
Article numberdjv264
Number of pages8
JournalJournal of the National Cancer Institute
Volume107
Issue number12
DOIs
Publication statusPublished - 1 Dec 2015

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Calcifediol
Melanoma
Confidence Intervals
Body Mass Index
Recurrence
Neoplasms
Survival
Serum
Proportional Hazards Models
Causality
Mass Spectrometry

Keywords

  • vitamin D
  • immune system
  • melanoma
  • melanoma patients
  • 25(OH)D3

Cite this

Saiag, P., Aegerter, P., Vitoux, D., Lebbé, C., Wolkenstein, P., Dupin, N., ... Boniol, M. (2015). Prognostic value of 25-hydroxyvitamin D3 levels at diagnosis and during follow-up in melanoma patients. Journal of the National Cancer Institute, 107(12), [djv264]. https://doi.org/10.1093/jnci/djv264
Saiag, Philippe ; Aegerter, Philippe ; Vitoux, Dominique ; Lebbé, Celeste ; Wolkenstein, Pierre ; Dupin, Nicolas ; Descamps, Vincent ; Aractingi, Selim ; Funck-Brentano, Elisa ; Autier, Philippe ; Dragomir, Miruna ; Boniol, Mathieu. / Prognostic value of 25-hydroxyvitamin D3 levels at diagnosis and during follow-up in melanoma patients. In: Journal of the National Cancer Institute. 2015 ; Vol. 107, No. 12.
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abstract = "A low 25-hydroxyvitamin D3 (25(OH)D3) serum concentration at melanoma diagnosis might be associated with worse survival. We prospectively studied the prognostic value of 25(OH)D3 at diagnosis and during follow-up. MelanCohort is a cohort of invasive melanoma patients. Serum 25(OH)D3 was measured by mass spectrometry and standardized on month of blood drawn, age, sex, and body mass index (BMI). Role of 25(OH)D3 levels and risk of relapse was analyzed in a Cox proportional hazards model adjusting for age, sex, BMI, and American Joint Committee on Cancer (AJCC) stage. All statistical tests were two-sided. One thousand one hundred seventy-one patients were included. 25(OH)D3 levels at diagnosis (median = 49.0 nmol/L) were inversely correlated with prognostic factors such as AJCC stage (P < .001 Kruskal-Wallis), Breslow's thickness (P < .001 Spearman correlation), and ulceration (P < .001 Kruskal-Wallis), but not with risk of relapse. Changes in 25(OH)D3 levels during follow-up were associated with worse prognosis: With a third quartile Q3 of average change per year (-0.30 to 4.60 nmol/L/Y) used as reference, hazard ratios for the first, second, and fourth quarters were 1.94 (95{\%} confidence interval [CI] = 1.36 to 2.76), 1.23 (95{\%} CI = 0.85 to 1.78), and 1.61 (95{\%} CI = 1.14 to 2.28), respectively. In sensitivity analyses, no changes were observed either by AJCC stage, number of 25(OH)D3 measures performed, or by 25(OH)D3 level at baseline. No evidence of reverse causation was identified. Analyses performed on overall survival yielded similar results. We show that 25(OH)D3 variation during follow-up is an independent melanoma prognostic marker, but not its level at diagnosis. Previously reported associations between low 25(OH)D3 level at diagnosis and poor prognosis seem to be due to insufficient adjustment for prognostic factors.",
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Saiag, P, Aegerter, P, Vitoux, D, Lebbé, C, Wolkenstein, P, Dupin, N, Descamps, V, Aractingi, S, Funck-Brentano, E, Autier, P, Dragomir, M & Boniol, M 2015, 'Prognostic value of 25-hydroxyvitamin D3 levels at diagnosis and during follow-up in melanoma patients' Journal of the National Cancer Institute, vol. 107, no. 12, djv264. https://doi.org/10.1093/jnci/djv264

Prognostic value of 25-hydroxyvitamin D3 levels at diagnosis and during follow-up in melanoma patients. / Saiag, Philippe; Aegerter, Philippe; Vitoux, Dominique; Lebbé, Celeste; Wolkenstein, Pierre; Dupin, Nicolas; Descamps, Vincent; Aractingi, Selim; Funck-Brentano, Elisa; Autier, Philippe; Dragomir, Miruna; Boniol, Mathieu.

In: Journal of the National Cancer Institute, Vol. 107, No. 12, djv264, 01.12.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic value of 25-hydroxyvitamin D3 levels at diagnosis and during follow-up in melanoma patients

AU - Saiag, Philippe

AU - Aegerter, Philippe

AU - Vitoux, Dominique

AU - Lebbé, Celeste

AU - Wolkenstein, Pierre

AU - Dupin, Nicolas

AU - Descamps, Vincent

AU - Aractingi, Selim

AU - Funck-Brentano, Elisa

AU - Autier, Philippe

AU - Dragomir, Miruna

AU - Boniol, Mathieu

N1 - This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of the National Cancer Institute following peer review. The definitive publisher-authenticated version Saiag, P., Aegerter, P., Vitoux, D., Lebbé, C., Wolkenstein, P., Dupin, N., ... Boniol, M. (2015). Prognostic value of 25-hydroxyvitamin D3 levels at diagnosis and during follow-up in melanoma patients. Journal of the National Cancer Institute, 107(12), [djv264]. http://jnci.oxfordjournals.org/content/107/12/djv264.abstract.

PY - 2015/12/1

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N2 - A low 25-hydroxyvitamin D3 (25(OH)D3) serum concentration at melanoma diagnosis might be associated with worse survival. We prospectively studied the prognostic value of 25(OH)D3 at diagnosis and during follow-up. MelanCohort is a cohort of invasive melanoma patients. Serum 25(OH)D3 was measured by mass spectrometry and standardized on month of blood drawn, age, sex, and body mass index (BMI). Role of 25(OH)D3 levels and risk of relapse was analyzed in a Cox proportional hazards model adjusting for age, sex, BMI, and American Joint Committee on Cancer (AJCC) stage. All statistical tests were two-sided. One thousand one hundred seventy-one patients were included. 25(OH)D3 levels at diagnosis (median = 49.0 nmol/L) were inversely correlated with prognostic factors such as AJCC stage (P < .001 Kruskal-Wallis), Breslow's thickness (P < .001 Spearman correlation), and ulceration (P < .001 Kruskal-Wallis), but not with risk of relapse. Changes in 25(OH)D3 levels during follow-up were associated with worse prognosis: With a third quartile Q3 of average change per year (-0.30 to 4.60 nmol/L/Y) used as reference, hazard ratios for the first, second, and fourth quarters were 1.94 (95% confidence interval [CI] = 1.36 to 2.76), 1.23 (95% CI = 0.85 to 1.78), and 1.61 (95% CI = 1.14 to 2.28), respectively. In sensitivity analyses, no changes were observed either by AJCC stage, number of 25(OH)D3 measures performed, or by 25(OH)D3 level at baseline. No evidence of reverse causation was identified. Analyses performed on overall survival yielded similar results. We show that 25(OH)D3 variation during follow-up is an independent melanoma prognostic marker, but not its level at diagnosis. Previously reported associations between low 25(OH)D3 level at diagnosis and poor prognosis seem to be due to insufficient adjustment for prognostic factors.

AB - A low 25-hydroxyvitamin D3 (25(OH)D3) serum concentration at melanoma diagnosis might be associated with worse survival. We prospectively studied the prognostic value of 25(OH)D3 at diagnosis and during follow-up. MelanCohort is a cohort of invasive melanoma patients. Serum 25(OH)D3 was measured by mass spectrometry and standardized on month of blood drawn, age, sex, and body mass index (BMI). Role of 25(OH)D3 levels and risk of relapse was analyzed in a Cox proportional hazards model adjusting for age, sex, BMI, and American Joint Committee on Cancer (AJCC) stage. All statistical tests were two-sided. One thousand one hundred seventy-one patients were included. 25(OH)D3 levels at diagnosis (median = 49.0 nmol/L) were inversely correlated with prognostic factors such as AJCC stage (P < .001 Kruskal-Wallis), Breslow's thickness (P < .001 Spearman correlation), and ulceration (P < .001 Kruskal-Wallis), but not with risk of relapse. Changes in 25(OH)D3 levels during follow-up were associated with worse prognosis: With a third quartile Q3 of average change per year (-0.30 to 4.60 nmol/L/Y) used as reference, hazard ratios for the first, second, and fourth quarters were 1.94 (95% confidence interval [CI] = 1.36 to 2.76), 1.23 (95% CI = 0.85 to 1.78), and 1.61 (95% CI = 1.14 to 2.28), respectively. In sensitivity analyses, no changes were observed either by AJCC stage, number of 25(OH)D3 measures performed, or by 25(OH)D3 level at baseline. No evidence of reverse causation was identified. Analyses performed on overall survival yielded similar results. We show that 25(OH)D3 variation during follow-up is an independent melanoma prognostic marker, but not its level at diagnosis. Previously reported associations between low 25(OH)D3 level at diagnosis and poor prognosis seem to be due to insufficient adjustment for prognostic factors.

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