Abstract
Background25-hydroxyvitamin D and active analogues have shown to inhibit growth of pancreatic cancer (PC) cell lines. However, studies describing the relationship between serum levels of vitamin D and survival in PC patients have shown conflicting results. The aim of the study was to evaluate the association between pre-treatment 25-hydroxyvitamin D levels and survival in Danish patients with PC. MethodsIn the prospective BIOPAC study (NCT03311776), the pre-treatment serum 25-hydroxyvitamin D (S-25(OH)D) concentrations were determined in 1233 patients with PC included from July 2008 to December 2018, using the DiaSorin Liaison 25-hydroxyvitamin D TOTAL assay. Age (median 67 years), gender (male/female: 675/558), BMI (<18.5/18.5-25/>25/unknown: 96/663/356/118), Performance status (PS) (0/1/2+3/unknown: 422/498/135/177) and stage (I+II/III+IV/unknown: 408/758/67) were retrieved. Survival was estimated in three S-25(OH)D groups as: insufficient <25nmol/L, relatively insufficient 25-50nmol/L and sufficient >50nmol/L. For survival analysis, Kaplan-Meier plots, log-rank tests and the Cox regression model were used. ResultsTable699PTableStageI+IIIII+IVS-25(OH)D levelsPt, No.mOS, months95%CIPt, No.mOS, months95%CISufficient20526.221.2-34.13837.26.2-8.1Relatively insufficient15622.918.3-27.82756.35.3-7.2Insufficient4715.711.3-30.21005.33.7-6.4Abbreviations: Pt, No.: Patient number, mOS: median overall survival, CI: Confidence interval. Overall survival between the three S-25(OH)D groups in stages I and II, log rank p=0.03, as well as in stages III and IV, log rank p=0.02, were significantly different. In the multivariate Cox regression analysis, patients with sufficient S-25(OH)D levels had longer survival than those with insufficient levels (HR=0.77, 95% CI 0.62-0.96; p=0.02). PS 0 vs. 1 and vs. 2+3 (p<0.01) and tumour stage I+II vs. III+IV (p<0.01) were also associated with longer survival whereas age, gender and BMI were not. ConclusionsPatients with PC and sufficient pre-treatment serum 25-hydroxyvitamin D levels had significantly longer OS than those with insufficient levels across all stages. Clinical trial identificationNCT03311776. Legal entity responsible for the studyJulia Sidenius Johansen. FundingAxel Muusfeldt’s Foundation. DisclosureAll authors have declared no conflicts of interest.
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