Facciorusso Antonio, Del Prete Valentina, Muscatiello Nicola, Crucinio Nicola, Barone Michele
Gastroenterology Unit, University of Foggia, Foggia, Italy.
J Gastroenterol Hepatol. 2016 Aug;31(8):1483-8. doi: 10.1111/jgh.13326.
Vitamin D is implicated in the etiology of several neoplastic diseases, but its relationship with colorectal cancer survival is still unclear. Aim of this study was to determine whether vitamin D levels influence survival outcomes in colorectal cancer liver metastases patients treated with percutaneous radiofrequency ablation.
We measured 25-hydroxyvitamin D levels in 143 patients with 215 colorectal liver metastases who underwent radiofrequency ablation between 1999 and 2011 at our institution. The influence of 25-hydroxyvitamin D levels on overall survival and time to recurrence was evaluated in univariate and multivariate Cox analyses.
Median age was 68 years (range 41-85), and median number of nodules was 2 (1-3) with a median maximum diameter of 26 mm (10-48). Median survival was 44 months (36-62), and survival rate was 91.4%, 46.5%, and 42.2% at 1, 4, and 5 years in the whole cohort. Median survival was 65 months (52-74) if 25-hydroxyvitamin D >20 ng/mL and 34 months (24-41) if ≤20 ng/mL (P < 0.001). In the whole cohort, median time to recurrence was 34 months (26-47), 50 months (36-62) in the case of 25-hydroxyvitamin D >20 ng/mL and 24 months (20-32) if ≤20 ng/mL (P < 0.001). Nodule size and 25-hydroxyvitamin D resulted as significant predictors of both overall survival and time to recurrence in multivariate analysis.
Our study provides support for the use of 25-hydroxyvitamin D as a new predictor of outcome for colorectal liver metastases patients.
维生素D与多种肿瘤性疾病的病因有关,但其与结直肠癌生存的关系仍不明确。本研究的目的是确定维生素D水平是否会影响接受经皮射频消融治疗的结直肠癌肝转移患者的生存结局。
我们测量了1999年至2011年在我院接受射频消融治疗的143例患者共215个结直肠癌肝转移灶的25-羟基维生素D水平。在单因素和多因素Cox分析中评估25-羟基维生素D水平对总生存和复发时间的影响。
中位年龄为68岁(范围41-85岁),结节中位数为2个(1-3个),最大直径中位数为26毫米(10-48毫米)。全队列的中位生存期为44个月(36-62个月),1年、4年和5年生存率分别为91.4%、46.5%和42.2%。25-羟基维生素D>20 ng/mL时中位生存期为65个月(52-74个月),≤20 ng/mL时为34个月(24-41个月)(P<0.001)。在全队列中,复发的中位时间为34个月(26-47个月),25-羟基维生素D>20 ng/mL时为50个月(36-62个月),≤20 ng/mL时为24个月(20-32个月)(P<0.001)。在多因素分析中,结节大小和25-羟基维生素D是总生存和复发时间的显著预测因素。
我们的研究支持将25-羟基维生素D用作结直肠癌肝转移患者预后的新预测指标。