Penelope M Webb1, Anna de Fazio2, Melinda M Protani3, Torukiri I Ibiebele4, Christina M Nagle4, Alison H Brand5, Penelope I Blomfield6, Peter Grant7, Lewis C Perrin8, Rachel E Neale4. 1. QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Australia; School of Population Health, University of Queensland, Herston, Australia; penny.webb@qimrberghofer.edu.au. 2. University of Sydney at Westmead Millennium Institute, Westmead Hospital, Sydney, Australia; 3. QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Australia; School of Population Health, University of Queensland, Herston, Australia; 4. QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Australia; 5. Department of Gynaecological Oncology, Westmead Hospital, University of Sydney, Westmead, Australia; 6. Department of Gynaecology Oncology, Royal Hobart Hospital, Hobart, Australia; 7. Gynaecological Oncology Unit, Mercy Hospital for Women, Melbourne, Australia; and. 8. Central Clinical Division, School of Medicine, Mater Health Services, The University of Queensland, South Brisbane, Australia.
Abstract
BACKGROUND: Vitamin D status might be associated with cancer survival. Survival after ovarian cancer is poor, but the association with vitamin D has rarely been examined. OBJECTIVE: We evaluated the association between serum 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D status, and ovarian cancer survival. DESIGN: Participants were women with invasive ovarian cancer diagnosed between 2002 and 2005 who participated in the Australian Ovarian Cancer Study. Serum samples, collected at diagnosis (n = 670) or after completion of primary treatment and before recurrence (n = 336), were assayed for 25(OH)D. Sociodemographic, dietary, and lifestyle data came from questionnaires self-completed at recruitment, and clinical and survival data were from medical records, supplemented by linkage to the Australian National Death Index (October 2011). Cox proportional hazards regression was used to estimate HRs and 95% CIs for the association between circulating 25(OH)D and survival. RESULTS: Overall, 59% of the women died during follow-up, with 95% of deaths resulting from ovarian cancer. Circulating 25(OH)D concentrations (mean: 44 nmol/L) were significantly associated with age, state of residence, season of blood collection, and body mass index but not with tumor histology, stage or grade, or comorbidities. Higher 25(OH)D concentrations at diagnosis were significantly associated with longer survival (adjusted HR: 0.93; 95% CI: 0.88, 0.99 per 10 nmol/L), but there was no significant association with progression-free survival or for 25(OH)D measured after primary treatment. CONCLUSIONS: In our cohort, higher serum 25(OH)D concentrations at diagnosis were associated with longer survival among women with ovarian cancer. If confirmed in other studies, this suggests that vitamin D status at diagnosis may be an independent predictor of prognosis. Furthermore, if the association is found to be causal, improving vitamin D status may improve ovarian cancer survival rates.
BACKGROUND:Vitamin D status might be associated with cancer survival. Survival after ovarian cancer is poor, but the association with vitamin D has rarely been examined. OBJECTIVE: We evaluated the association between serum 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D status, and ovarian cancer survival. DESIGN:Participants were women with invasive ovarian cancer diagnosed between 2002 and 2005 who participated in the Australian Ovarian Cancer Study. Serum samples, collected at diagnosis (n = 670) or after completion of primary treatment and before recurrence (n = 336), were assayed for 25(OH)D. Sociodemographic, dietary, and lifestyle data came from questionnaires self-completed at recruitment, and clinical and survival data were from medical records, supplemented by linkage to the Australian National Death Index (October 2011). Cox proportional hazards regression was used to estimate HRs and 95% CIs for the association between circulating 25(OH)D and survival. RESULTS: Overall, 59% of the women died during follow-up, with 95% of deaths resulting from ovarian cancer. Circulating 25(OH)D concentrations (mean: 44 nmol/L) were significantly associated with age, state of residence, season of blood collection, and body mass index but not with tumor histology, stage or grade, or comorbidities. Higher 25(OH)D concentrations at diagnosis were significantly associated with longer survival (adjusted HR: 0.93; 95% CI: 0.88, 0.99 per 10 nmol/L), but there was no significant association with progression-free survival or for 25(OH)D measured after primary treatment. CONCLUSIONS: In our cohort, higher serum 25(OH)D concentrations at diagnosis were associated with longer survival among women with ovarian cancer. If confirmed in other studies, this suggests that vitamin D status at diagnosis may be an independent predictor of prognosis. Furthermore, if the association is found to be causal, improving vitamin D status may improve ovarian cancer survival rates.
Authors: Johanna E Torfadottir; Thor Aspelund; Unnur A Valdimarsdottir; Mary Frances Cotch; Laufey Tryggvadottir; Tamara B Harris; Vilmundur Gudnason; Hans-Olov Adami; Lorelei A Mucci; Edward L Giovannucci; Meir J Stampfer; Laufey Steingrimsdottir Journal: Cancer Causes Control Date: 2019-02-25 Impact factor: 2.506
Authors: P G Vaughan-Shaw; F O'Sullivan; S M Farrington; E Theodoratou; H Campbell; M G Dunlop; L Zgaga Journal: Br J Cancer Date: 2017-03-16 Impact factor: 7.640
Authors: Jue-Sheng Ong; Gabriel Cuellar-Partida; Yi Lu; Peter A Fasching; Alexander Hein; Stefanie Burghaus; Matthias W Beckmann; Diether Lambrechts; Els Van Nieuwenhuysen; Ignace Vergote; Adriaan Vanderstichele; Jennifer Anne Doherty; Mary Anne Rossing; Jenny Chang-Claude; Ursula Eilber; Anja Rudolph; Shan Wang-Gohrke; Marc T Goodman; Natalia Bogdanova; Thilo Dörk; Matthias Dürst; Peter Hillemanns; Ingo B Runnebaum; Natalia Antonenkova; Ralf Butzow; Arto Leminen; Heli Nevanlinna; Liisa M Pelttari; Robert P Edwards; Joseph L Kelley; Francesmary Modugno; Kirsten B Moysich; Roberta B Ness; Rikki Cannioto; Estrid Høgdall; Claus K Høgdall; Allan Jensen; Graham G Giles; Fiona Bruinsma; Susanne K Kjaer; Michelle At Hildebrandt; Dong Liang; Karen H Lu; Xifeng Wu; Maria Bisogna; Fanny Dao; Douglas A Levine; Daniel W Cramer; Kathryn L Terry; Shelley S Tworoger; Meir Stampfer; Stacey Missmer; Line Bjorge; Helga B Salvesen; Reidun K Kopperud; Katharina Bischof; Katja Kh Aben; Lambertus A Kiemeney; Leon Fag Massuger; Angela Brooks-Wilson; Sara H Olson; Valerie McGuire; Joseph H Rothstein; Weiva Sieh; Alice S Whittemore; Linda S Cook; Nhu D Le; C Blake Gilks; Jacek Gronwald; Anna Jakubowska; Jan Lubiński; Tomasz Kluz; Honglin Song; Jonathan P Tyrer; Nicolas Wentzensen; Louise Brinton; Britton Trabert; Jolanta Lissowska; John R McLaughlin; Steven A Narod; Catherine Phelan; Hoda Anton-Culver; Argyrios Ziogas; Diana Eccles; Ian Campbell; Simon A Gayther; Aleksandra Gentry-Maharaj; Usha Menon; Susan J Ramus; Anna H Wu; Agnieszka Dansonka-Mieszkowska; Jolanta Kupryjanczyk; Agnieszka Timorek; Lukasz Szafron; Julie M Cunningham; Brooke L Fridley; Stacey J Winham; Elisa V Bandera; Elizabeth M Poole; Terry K Morgan; Harvey A Risch; Ellen L Goode; Joellen M Schildkraut; Celeste L Pearce; Andrew Berchuck; Paul Dp Pharoah; Georgia Chenevix-Trench; Puya Gharahkhani; Rachel E Neale; Penelope M Webb; Stuart MacGregor Journal: Int J Epidemiol Date: 2016-09-04 Impact factor: 7.196