Association of Vitamin D Levels With Outcome in Patients With Melanoma After Adjustment For C-Reactive Protein.

Journal Article (Journal Article)

PURPOSE: To evaluate for an association between 25-hydroxyvitamin D levels (vitamin D) and outcome measures in patients with melanoma after evaluation is controlled for systemic inflammatory response (SIR) on the basis of simultaneous C-reactive protein (CRP) measurement. MATERIALS AND METHODS: Plasma samples from 1,042 prospectively observed patients with melanoma were assayed for vitamin D and CRP. The associations of demographics and CRP with vitamin D were determined, followed by a determination of the association between vitamin D and stage and outcome measures from the date of blood draw. The vitamin D level was considered sufficient if it was 30 to 100 ng/mL. Kaplan-Meier and Cox regression analyses were performed. RESULTS: The median vitamin D level was 25.0 ng/mL. The median follow-up time was 7.1 years. A lower vitamin D was associated with the blood draw during fall/winter months (P < .001), older age (P = .001), increased CRP (P < .001), increased tumor thickness (P < .001), ulcerated tumor (P = .0105), and advanced melanoma stage (P = .0024). On univariate analysis, lower vitamin D was associated with poorer overall (OS; P < .001), melanoma-specific survival (MSS; P = .0025), and disease-free survival (DFS; P = .0466). The effect of vitamin D on these outcome measures persisted after adjustment for CRP and other covariates. Multivariable hazards ratios per unit decrease of vitamin D were 1.02 for OS (95% CI, 1.01 to 1.04; P = .0051), 1.02 for MSS (95% CI, 1.00 to 1.04; P = .048), and 1.02 for DFS (95% CI, 1.00 to 1.04; P = .0427). CONCLUSION: Lower vitamin D levels in patients with melanoma were associated with poorer outcomes. Although lower vitamin D was strongly associated with higher CRP, the associations of lower vitamin D with poorer OS, MSS, and DFS were independent of this association. Investigation of mechanisms responsible for these associations may be of value to patients with melanoma.

Full Text

Duke Authors

Cited Authors

  • Fang, S; Sui, D; Wang, Y; Liu, H; Chiang, Y-J; Ross, MI; Gershenwald, JE; Cormier, JN; Royal, RE; Lucci, A; Wargo, J; Hu, MI; Gardner, JM; Reveille, JD; Bassett, RL; Wei, Q; Amos, CI; Lee, JE

Published Date

  • May 20, 2016

Published In

Volume / Issue

  • 34 / 15

Start / End Page

  • 1741 - 1747

PubMed ID

  • 27001565

Pubmed Central ID

  • PMC4966337

Electronic International Standard Serial Number (EISSN)

  • 1527-7755

Digital Object Identifier (DOI)

  • 10.1200/JCO.2015.64.1357


  • eng

Conference Location

  • United States