title: Serum 25-hydroxyvitamin D3 levels are associated with breslow thickness at presentation and survival from melanoma.
abstract: OBJECTIVE
  A cohort study was carried out to test the hypothesis that higher vitamin D levels reduce the risk of relapse from melanoma.
  
  
  METHODS
  A pilot retrospective study of 271 patients with melanoma suggested that vitamin D may protect against recurrence of melanoma. We tested these findings in a survival analysis in a cohort of 872 patients recruited to the Leeds Melanoma Cohort (median follow-up, 4.7 years).
  
  
  RESULTS
  In the retrospective study, self-reports of taking vitamin D supplements were nonsignificantly correlated with a reduced risk of melanoma relapse (odds ratio = 0.6; 95% CI, 0.4 to 1.1; P = .09). Nonrelapsers had higher mean 25-hydroxyvitamin D(3) levels than relapsers (49 v 46 nmol/L; P = .3; not statistically significant). In the cohort (prospective) study, higher 25-hydroxyvitamin D(3) levels were associated with lower Breslow thickness at diagnosis (P = .002) and were independently protective of relapse and death: the hazard ratio for relapse-free survival (RFS) was 0.79 (95% CI, 0.64 to 0.96; P = .01) for a 20 nmol/L increase in serum level. There was evidence of interaction between the vitamin D receptor (VDR) BsmI genotype and serum 25-hydroxyvitamin D(3) levels on RFS.
  
  
  CONCLUSIONS
  Results from the retrospective study were consistent with a role for vitamin D in melanoma outcome. The cohort study tests this hypothesis, providing evidence that higher 25-hydroxyvitamin D(3) levels, at diagnosis, are associated with both thinner tumors and better survival from melanoma, independent of Breslow thickness. Patients with melanoma, and those at high risk of melanoma, should seek to ensure vitamin D sufficiency. Additional studies are needed to establish optimal serum levels for patients with melanoma.
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, St James's Hospital, Beckett St, Leeds LS9 7TF, United Kingdom. j.a.newton-bishop@leeds.ac.uk
authors.forename: Julia A
authors.initials: JA
authors.lastname: Newton-Bishop
authors.forename: Samantha
authors.initials: S
authors.lastname: Beswick
authors.forename: Juliette
authors.initials: J
authors.lastname: Randerson-Moor
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Chang
authors.forename: Paul
authors.initials: P
authors.lastname: Affleck
authors.forename: Faye
authors.initials: F
authors.lastname: Elliott
authors.forename: May
authors.initials: M
authors.lastname: Chan
authors.forename: Susan
authors.initials: S
authors.lastname: Leake
authors.forename: Birute
authors.initials: B
authors.lastname: Karpavicius
authors.forename: Sue
authors.initials: S
authors.lastname: Haynes
authors.forename: Kairen
authors.initials: K
authors.lastname: Kukalizch
authors.forename: Linda
authors.initials: L
authors.lastname: Whitaker
authors.forename: Sharon
authors.initials: S
authors.lastname: Jackson
authors.forename: Edwina
authors.initials: E
authors.lastname: Gerry
authors.forename: Clarissa
authors.initials: C
authors.lastname: Nolan
authors.forename: Chandra
authors.initials: C
authors.lastname: Bertram
authors.forename: Jerry
authors.initials: J
authors.lastname: Marsden
authors.forename: David E
authors.initials: DE
authors.lastname: Elder
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Barrett
authors.forename: D Timothy
authors.initials: DT
authors.lastname: Bishop
mesh_terms: D002112:Calcifediol / Q000097:blood*; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D010865:Pilot Projects; D012189:Retrospective Studies; D016019:Survival Analysis; D014807:Vitamin D / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D014815:Vitamins; D014807:Vitamin D; D002112:Calcifediol