Prognostic value of vitamin-D level in non-metastatic breast cancer patients in Saudi Arabia

Shereef Elsamany, Omaima Elemam, Ahmed Zeeneldin, Soha Elmorsy, Ahmed Khatry, Faisal Alhuthali, Suha Alsayed
2020 Asian Pacific Journal of Cancer Care  
Deficiency of vitamin-D (Vit-D) was associated with poor survival outcome in several studies across different tumour types. The present study aims to assess the prevalence and prognostic value of Vit-D deficiency among breast cancer patients in a single institution in Saudi Arabia. Methods In this retrospective study, we screened patients who presented with non-metastatic breast cancer to King Abdullah Medical City, Saudi Arabia from June 2011 to December 2015. We checked baseline Vit-D level
more » ... eline Vit-D level before starting systemic therapy in addition to other clinicopathological factors. Low Vit-D was defined as Vit-D level less than 30 ng /ml. The relations of Vit-D level (taking the median as the cutoff) with clinicopathological factors were assessed using Chi-Square test. Differences in survival outcome were compared using log rank test. Results We screened 340 patients with non-metastatic breast cancer. Baseline Vit-D levels were available for 189 patients. The median age was 50 years (range: 26- 86 years). Noteworthy, 169 (89.4%) of patients had Vit-D level <30 ng/ml with a median of 14.9 ng/ml (range: 4.0 - 45.0). Low Vit-D level (below the median) was significantly more common in premenopausal (p=0.011) and ER-negative patients (p=0.011). However, lymphovascular invasion (p=0.001), clinically (p=0.023) and pathologically positive axillary LNs (p=0.041) were linked with higher Vit- D level. After a median follow up period of 58.2 months, 14 patients died and 40 relapsed. The 5-year disease-free survival (DFS) rates was 74.8%. The 5-year DFS rate in patients with higher Vit-D level above the median was 78.8% compared to 71.1% in patients with lower Vit-D level with no statistically significance difference (p= 0.22). The 5-year overall survival (OS) rate was 90.2%. Meanwhile, no difference in 5-year OS rate in patients with higher and lower Vit-D levels (90.3% and 89.7% respectively, p=0.6). Conclusion Low Vit-D level was prevalent among the studied breast cancer patients. Low Vit-D level was associated with ER-negative phenotype and premenopausal patients. Baseline Vit-D level was not significantly linked with survival outcome.
doi:10.31557/apjcc.2020.1.1.9-14 fatcat:iyjjawcx5rarflthhi5kuabr3e