Lim Seung Taek, Jeon Ye Won, Suh Young Jin
Department of Surgery, Division of Breast and Thyroid Surgical Oncology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Kyunggi-do, Korea E-mail :
Asian Pac J Cancer Prev. 2015;16(6):2507-13. doi: 10.7314/apjcp.2015.16.6.2507.
Serum vitamin D status can affect the prognosis of breast cancer patients. Our aim was to determine the association between alterations in the 25-hydroxyvitamin D [25(OH)D] status during follow-up and the prognosis of breast cancer patients. Additionally, we evaluated the association between the 25(OH)D status at the time of diagnosis and the prognosis using a detailed age and stage categorization.
Four hundred and sixty-nine Korean breast cancer patients were included. We collected patient clinicopathological data, including their serum 25(OH)D concentration at diagnosis and at the annual follow- up until 4 years after diagnosis. The patients were divided according to their 25(OH)D status at diagnosis into a deficient (<20 ng/ml) and a non-deficient (≥20 ng/ml) group. At follow-up, patients were categorized into the four following groups according to 25(OH)D status alterations: persistently deficient, improved, deteriorated and persistently non-deficient.
At diagnosis, 118 patients were classified into the deficient group and 351 into the non-deficient group. After a median follow-up period of 85.8±31.0 months, the patients with advanced- stage disease or an older age in the non-deficient group showed a significantly better survival compared with the deficient group. Furthermore, at the 1-year follow-up of 25(OH)D status, the persistently non-deficient group and the improved group had better survival compared with the other two groups.
Our results suggest that maintaining an optimal 25(OH)D status at diagnosis and during the 1-year follow-up period is important for improving breast cancer patient survival.
血清维生素D水平会影响乳腺癌患者的预后。我们的目的是确定随访期间25-羟基维生素D[25(OH)D]水平的变化与乳腺癌患者预后之间的关联。此外,我们使用详细的年龄和分期分类评估了诊断时25(OH)D水平与预后之间的关联。
纳入469例韩国乳腺癌患者。我们收集了患者的临床病理数据,包括诊断时以及诊断后至4年每年随访时的血清25(OH)D浓度。根据诊断时的25(OH)D水平将患者分为缺乏组(<20 ng/ml)和非缺乏组(≥20 ng/ml)。在随访时,根据25(OH)D水平变化将患者分为以下四组:持续缺乏组、改善组、恶化组和持续非缺乏组。
诊断时,118例患者被分类为缺乏组,351例为非缺乏组。中位随访期为85.8±31.0个月后,非缺乏组中晚期疾病患者或年龄较大的患者的生存率明显高于缺乏组。此外,在对25(OH)D水平进行1年随访时,持续非缺乏组和改善组的生存率高于其他两组。
我们的结果表明,在诊断时以及1年随访期间维持最佳的25(OH)D水平对于提高乳腺癌患者的生存率很重要。