Zhou Wei, Suk Rebecca, Liu Geoffrey, Park Sohee, Neuberg Donna S, Wain John C, Lynch Thomas J, Giovannucci Edward, Christiani David C
Occupational Health Program, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
Cancer Epidemiol Biomarkers Prev. 2005 Oct;14(10):2303-9. doi: 10.1158/1055-9965.EPI-05-0335.
Vitamin D may inhibit the development and progression of a wide spectrum of cancers. We investigated the associations of surgery season and vitamin D intake with recurrence-free survival (RFS) and overall survival in 456 early-stage non-small cell lung cancer patients. The data were analyzed using log-rank test and Cox proportional hazards models. The median (range) follow-up time was 71 (0.1-140) months, with 161 recurrence and 231 deaths. Patients who had surgery in summer had a better RFS than those who had surgery in winter (adjusted hazard ratio, 0.75; 95% confidence interval, 0.56-1.01), with 5-year RFS rates of 53% (45-61%) and 40% (32-49%), respectively (P = 0.10, log-rank test). Similar association between surgery season and RFS was found among the 321 patients with dietary information (P = 0.33, log-rank test). There was no statistically significant association between vitamin D intake and RFS. Because both season and vitamin D intake are important predictors for vitamin D levels, we investigated the joint effects of surgery season and vitamin D intake. Patients who had surgery during summer with the highest vitamin D intake had better RFS (adjusted hazard ratio, 0.33; 95% confidence interval, 0.15-0.74) than patients who had surgery during winter with the lowest vitamin D intake, with the 5-year RFS rates of 56% (34-78%) and 23% (4-42%), respectively. Similar associations of surgery season and vitamin D intake with overall survival were also observed. In conclusion, the joint effects of surgery season and recent vitamin D intake seem to be associated with the survival of early-stage non-small cell lung cancer patients.
维生素D可能会抑制多种癌症的发生和发展。我们调查了456例早期非小细胞肺癌患者的手术季节和维生素D摄入量与无复发生存期（RFS）及总生存期的关系。采用对数秩检验和Cox比例风险模型对数据进行分析。中位（范围）随访时间为71（0.1 - 140）个月，有161例复发和231例死亡。夏季进行手术的患者的无复发生存期优于冬季进行手术的患者（校正风险比，0.75；95%置信区间，0.56 - 1.01），5年无复发生存率分别为53%（45 - 61%）和40%（32 - 49%）（P = 0.10，对数秩检验）。在321例有饮食信息的患者中也发现了手术季节与无复发生存期之间的类似关联（P = 0.33，对数秩检验）。维生素D摄入量与无复发生存期之间无统计学显著关联。由于季节和维生素D摄入量都是维生素D水平的重要预测因素，我们研究了手术季节和维生素D摄入量的联合作用。夏季进行手术且维生素D摄入量最高的患者的无复发生存期优于冬季进行手术且维生素D摄入量最低的患者（校正风险比，0.33；95%置信区间，0.15 - 0.74），5年无复发生存率分别为56%（34 - 78%）和23%（4 - 42%）。手术季节和维生素D摄入量与总生存期之间也观察到类似关联。总之，手术季节和近期维生素D摄入量的联合作用似乎与早期非小细胞肺癌患者的生存相关。
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