Abstract
AimsVitamin D receptor (VDR) expression has been associated with survival in several cancer sites. This study aims to evaluate the association between VDR expression and prognosis in oesophageal adenocarcinoma patients.ResultsDuring a median of 2.5 (maximum 9) years of follow-up, 75 patients died. In analysis adjusted for confounders, higher VDR expression was associated with an improved overall survival (HR 0.49 95% CI 0.25–0.96) and disease-specific survival (HR 0.50 95% CI 0.26–0.99), when comparing the highest with the lowest tertile of expression. These associations were strongest in sensitivity analysis restricted to junctional tumours.ConclusionsThis study is the first to demonstrate that patients with higher VDR expression in oesophageal adenocarcinoma have a more favourable prognosis. Further work is needed to validate these findings, and to define the role of VDR in the aetiology, progression and management of oesophageal adenocarcinoma.MethodsOesophageal adenocarcinoma specimens and clinical data were collected from 130 patients treated with neo-adjuvant chemotherapy prior to surgical resection at the Northern Ireland Cancer Centre between 2004 and 2012. Tissue microarrays were created and immunohistochemical staining for VDR was performed on triplicate tumour cores from each resection specimen. Cox proportional hazards models were applied to evaluate associations between VDR, according to tertiles of expression, and survival outcomes.
Highlights
Oesophageal cancer causes 400,000 deaths worldwide each year and ranks as the sixth most common cause of cancer mortality [1]
In analysis adjusted for confounders, higher vitamin D receptor (VDR) expression was associated with an improved overall survival (HR 0.49 95% CI 0.25–0.96) and disease-specific survival (HR 0.50 95% CI 0.26–0.99), when comparing the highest with the lowest tertile of expression
This study is the first to demonstrate that patients with higher VDR expression in oesophageal adenocarcinoma have a more favourable prognosis
Summary
Oesophageal cancer causes 400,000 deaths worldwide each year and ranks as the sixth most common cause of cancer mortality [1]. Neo-adjuvant therapy has somewhat improved prognosis, 5-year survival rates for this malignancy still only range between 10% and 18% in Western settings [2, 3] These low figures are partially related to more than 30% of oesophageal cancer patients having metastatic disease at first presentation [2]. In-vitro studies within colorectal cancer cell lines have demonstrated that cells with high VDR expression tend to be well differentiated and are biologically favourable, whereas cell lines with low VDR expression demonstrated aggressive features with higher metastatic potential [7]. These findings have been translated in clinical studies which have shown that high VDR expression has been associated with increased survival in colorectal, pancreatic and breast cancer, cutaneous melanoma, urothelial bladder cancer and oesophageal squamous cell carcinoma [8,9,10,11,12,13]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
