Multivitamin use is not associated with cancer recurrence or survival in patients with stage III colon cancer: findings from CALGB 89803.
OBJECTIVE
Multivitamin use is widespread in the United States, especially among patients with cancer. However, the influence of multivitamin supplementation on cancer recurrence and death after a curative resection of colon cancer is unknown.


METHODS
We conducted a prospective, observational study of 1,038 patients with stage III colon cancer enrolled in a randomized adjuvant chemotherapy trial. Patients reported on multivitamin use during and 6 months after adjuvant chemotherapy. Patients were observed until March 2009 for disease recurrence and death. To minimize bias by occult recurrence, we excluded patients who recurred or died within 90 days of their multivitamin assessment.


RESULTS
Among 1,038 patients, 518 (49.9%) reported multivitamin use during adjuvant chemotherapy. Compared with nonusers, the multivariate hazard ratio (HR) for disease-free survival was 0.94 (95% CI, 0.77 to 1.15) for patients who used multivitamins. Similarly, multivitamin use during adjuvant chemotherapy was not significantly associated with recurrence-free survival (multivariate HR, 0.93; 95% CI, 0.75 to 1.15) or overall survival (multivariate HR 0.92; 95% CI, 0.74 to 1.16). Multivitamin use reported 6 months after completion of adjuvant chemotherapy was also not associated with improved patient outcome, and consistent use both during and following adjuvant therapy conferred no benefit. Neither an increasing number of tablets nor increasing duration of use before cancer diagnosis was associated with cancer recurrence or mortality. Multivitamin use also did not improve the rates of grade 3 and higher GI toxicity.


CONCLUSIONS
Multivitamin use during and after adjuvant chemotherapy was not significantly associated with improved outcomes in patients with stage III colon cancer.
Ng
Kimmie
K
Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA. kng4@partners.org
Meyerhardt
Jeffrey A
JA
Chan
Jennifer A
JA
Niedzwiecki
Donna
D
Hollis
Donna R
DR
Saltz
Leonard B
LB
Mayer
Robert J
RJ
Benson
Al B
AB
Schaefer
Paul L
PL
Whittom
Renaud
R
Hantel
Alexander
A
Goldberg
Richard M
RM
Fuchs
Charles S
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage*
D014815:Vitamins
Am J Epidemiol. 2006 Jan 15;163(2):108-15
16339055
NIH Consens State Sci Statements. 2006 May 15-17;23(2):1-30
17332802
Int J Cancer. 1999 May 31;81(5):730-3
10328225
Cancer Res. 2000 Apr 15;60(8):2304-12
10786699
Am J Clin Nutr. 2007 Jan;85(1):314S-317S
17209217
Am J Epidemiol. 2003 Oct 1;158(7):621-8
14507597
Tumori. 2009 Jul-Aug;95(4):508-13
19856665
Ann Intern Med. 1998 Oct 1;129(7):517-24
9758570
Oncol Rep. 2005 Mar;13(3):421-5
15706410
Lancet. 2002 Apr 13;359(9314):1309-10
11965278
JAMA. 2007 Jun 6;297(21):2351-9
17551129
Mol Nutr Food Res. 2007 Mar;51(3):267-92
17295418
Diabetes Metab Res Rev. 2009 Nov;25(8):733-9
19780064
Anticancer Res. 1988 Jul-Aug;8(4):739-48
3052251
Ann N Y Acad Sci. 2001 Dec;952:73-87
11795445
Am J Prev Med. 2007 Mar;32(3):210-6
17296473
J Clin Oncol. 2008 Jun 20;26(18):2984-91
18565885
Int J Cancer. 2005 Feb 20;113(5):825-8
15499620
J Nutr Biochem. 1999 Feb;10(2):66-88
15539274
Cancer Epidemiol Biomarkers Prev. 1997 Oct;6(10):769-74
9332757
J Clin Oncol. 2008 Jul 1;26(19):3222-8
18591557
J Natl Cancer Inst. 2006 Apr 5;98(7):451-9
16595781
Ann Thorac Surg. 2008 Apr;85(4):1155-7
18355488
JAMA. 2008 Jun 4;299(21):2515-23
18523220
J Clin Oncol. 2006 Aug 1;24(22):3535-41
16822843
J Nutr. 2002 Aug;132(8 Suppl):2413S-2418S
12163703
Biometrics. 1989 Mar;45(1):157-70
2655728
Cancer Lett. 1995 Oct 20;97(1):99-106
7585485
J Clin Oncol. 2008 Feb 1;26(4):665-73
18235127
J Clin Oncol. 2009 Apr 10;27(11):1814-21
19273709
Arch Intern Med. 2009 Feb 9;169(3):294-304
19204221
J Clin Oncol. 2007 Aug 10;25(23):3456-61
17687149
J Nutr. 2002 Aug;132(8 Suppl):2350S-2355S
12163691
Am J Epidemiol. 2003 May 15;157(10):944-54
12746248
Mol Carcinog. 2008 Apr;47(4):264-74
17918208