A Role for Vitamin D in the Gastro-Entero-Pancreatic Neuroendocrine Neoplasms Outcome: Report on a Series from a Single Institute

Abstract

Background/Aims: Vitamin D deficiency is hypothesized to represent a risk factor in several neoplasms. The aim of this study was to determine whether serum 25-hydroxyvitamin D (25-OHvitD) deficiency represents a risk factor for neuroendocrine neoplasms (NEN) and can be associated to overall survival (OS) and progression-free survival (PFS).

Methods: From 2010 to 2015, 138 patients with gastro-entero-pancreatic NENs (F=61, median age 63 years) were included in the study. Serum 25-OHvitD levels, which were measured at baseline, were defined as deficient if <20 ng/ml. In such cases 25-OHvitD supplementation was administered to the patients. The possible associations between 25-OHvitD levels and disease grading, staging, overall OS and PFS were considered. Furthermore, the possible association between 25-OHvitD supplementation and PFS or OS was evaluated by Cox’s proportional hazards regression.

Results: Median 25-OHvitD levels were 12.9 ng/ml (range 2–32): in detail, 94 patients (68%) had <20 ng/ml, with 46 cases (33%) having <10 ng/ml. An inverse correlation was observed between 25-OHvitD levels and OS (p=0.03, r.s.=-0.18) and PFS (p=0.01, r.s.=-0.22). At Cox’s proportional hazards regression, mortality was not related to 25-OHvitD levels; however, there was an association between 25-OHvitD supplementation and OS (p <0.002).

Conclusions: Vitamin D deficiency is highly prevalent among NEN patients. 25-OHvitD supplementation potentially plays an important role not only in the correction of 25-OHvitD values, but also for its influence on the clinical outcome. However, further studies are needed to confirm this observation.

About this publication.

See also:

- Vitamin D (analogues and/or derivatives) and cancer;

- Oesophageal squamocellular carcinoma: a complete and objective response;

- Pancreatic Adenocarcinoma: clinical records on 17 patients treated with Di Bella's Method;

- The Di Bella Method Increases by the 30% the survival rate for Pancreas tumors and for this reason should be proposed as first line therapy for this type of cancer;

- Somatostatin, retinoids, melatonin, vitamin D, bromocriptine, and cyclophosphamide in advanced non-small-cell lung cancer patients with low performance status;

- Somatostatin, retinoids, melatonin, vitamin D, bromocriptine, and cyclophosphamide in chemotherapy-pretreated patients with advanced lung adenocarcinoma and low performance status;

- Observations on the Report of a case of pulmonary adenocarcinoma with lymph node, hepatic and osseus metastasis;

- Evaluation of the safety and efficacy of the first-line treatment with somatostatin combined with melatonisn, retinoids, vitamin D3, and low doses of cyclophosphamide in 20 cases of breast cancer: a preliminary report;

- The Di Bella Method (DBM) improved survival, objective response and performance status in a retrospective observational clinical study on 122 cases of breast cancer;

- Complete objective response to biological therapy of plurifocal breast carcinoma;