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Nutrients. 2018 Jul 13;10(7). pii: E896. doi: 10.3390/nu10070896.

Association between Blood 25-Hydroxyvitamin D Levels and Survival in Colorectal Cancer Patients: An Updated Systematic Review and Meta-Analysis.

Author information

1
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany. h.maalmi@DKFZ.de.
2
Network Aging Research (NAR), Heidelberg University, Bergheimer Strasse 20, Heidelberg 69115, Germany. h.maalmi@DKFZ.de.
3
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany. viola.walter@gmx.net.
4
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany. l.jansen@DKFZ.de.
5
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany. d.boakye@DKFZ.de.
6
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany. b.schoettker@DKFZ.de.
7
Network Aging Research (NAR), Heidelberg University, Bergheimer Strasse 20, Heidelberg 69115, Germany. b.schoettker@DKFZ.de.
8
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany. m.hoffmeister@DKFZ.de.
9
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany. h.brenner@DKFZ-Heidelberg.de.
10
Network Aging Research (NAR), Heidelberg University, Bergheimer Strasse 20, Heidelberg 69115, Germany. h.brenner@DKFZ-Heidelberg.de.
11
German Cancer Consortium, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany. h.brenner@DKFZ-Heidelberg.de.

Abstract

Previous meta-analyses have shown an improved survival with higher blood 25-hydroxyvitamin D (25(OH)D) concentrations in patients with colorectal cancer (CRC). However, a number of much larger studies have been published since then. We provide an updated meta-analysis to synthesize current evidence. PubMed and Web of Science databases were systematically searched for eligible studies. The dose-response relationships and pooled hazard ratios for overall and CRC-specific survival comparing the highest versus the lowest categories of blood 25(OH)D concentrations were assessed. Subgroup analyses based on study geographic location, year of publication, sample size, length of follow-up time and stage were conducted to explore potential sources of heterogeneity. Overall, 11 original studies with a total of 7718 CRC patients were included. The dose-response meta-analysis showed an improvement in survival outcomes with increasing blood 25(OH)D concentrations. Pooled hazard ratios (95% confidence intervals) comparing highest versus lowest categories were 0.68 (0.55⁻0.85) and 0.67 (0.57⁻0.78) for overall and CRC-specific survival, respectively. Associations were more prominent among studies conducted in Europe, with larger sample sizes, and including stage I⁻IV patients. This updated meta-analysis reveals robust evidence of an association between higher blood 25(OH)D concentrations and better survival in CRC patients. The potential for enhancing prognosis of CRC patients by vitamin D supplementation should be explored by randomized trials.

KEYWORDS:

cohort studies; colorectal cancer; dose-response; meta-analysis; mortality; vitamin D

PMID:
30011816
PMCID:
PMC6073902
DOI:
10.3390/nu10070896
[Indexed for MEDLINE]
Free PMC Article

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