title: Circulating 25-hydroxyvitamin D levels predict survival in early-stage non-small-cell lung cancer patients.
abstract: OBJECTIVE
  Our previous analyses suggested that surgery in the summertime with higher vitamin D intake is associated with improved survival in patients with early-stage non-small-cell lung cancer (NSCLC). We further investigated the results of circulating 25-hydroxyvitamin D (25[OH]D) levels on overall survival (OS) and recurrence-free survival (RFS) in NSCLC patients.
  
  
  METHODS
  Among 447 patients with early-stage NSCLC, data were analyzed using Cox proportional hazards models, adjusting for age, sex, stage, smoking, and treatment.
  
  
  RESULTS
  The median follow-up time was 72 months (range, 0.2 to 141), with 161 recurrences and 234 deaths. For OS, the adjusted hazard ratio (AHR) was 0.74 (95% CI, 0.50 to 1.10; Ptrend = .07) for the highest versus lowest quartile of 25(OH)D levels. Stratified by stage, a strong association was observed among stage IB-IIB patients (AHR, 0.45; 95% CI, 0.24 to 0.82; Ptrend = .002), but not among stage IA patients (AHR, 1.10; 95% CI, 0.62 to 1.96; Ptrend = .53). Similar effects of 25(OH)D levels were observed among the 309 patients with dietary information (AHR, 0.74; 95% CI, 0.46 to 1.17; Ptrend = .19). For the joint effects of 25(OH)D level and vitamin D intake, the combined high 25(OH)D levels and high vitamin D intake (by median) were associated with better survival than the combined low 25(OH)D levels and low vitamin D intake (AHR, 0.64; 95% CI, 0.42 to 0.98; Ptrend = .06). Again, stronger associations were observed among stage IB-IIB than IA patients. Similar effects of 25(OH)D levels and vitamin D intake were observed for RFS.
  
  
  CONCLUSIONS
  Vitamin D may be associated with improved survival of patients with early-stage NSCLC, particularly among stage IB-IIB patients.
authors.affiliation: Departments of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA. wzhou@hsph.harvard.edu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Heist
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Liu
authors.forename: Kofi
authors.initials: K
authors.lastname: Asomaning
authors.forename: Donna S
authors.initials: DS
authors.lastname: Neuberg
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Hollis
authors.forename: John C
authors.initials: JC
authors.lastname: Wain
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Lynch
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Li
authors.initials: L
authors.lastname: Su
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D004032:Diet; D019587:Dietary Supplements; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012621:Seasons; D013997:Time Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D