Research Article
BibTex RIS Cite

Neoadjuvan Tedavi Alan Rektum Kanseri Hastalarında D Vitamininin Rolü

Year 2026, Volume: 79 Issue: 1, 40 - 46, 27.03.2026
https://doi.org/10.65092/autfm.1788633
https://izlik.org/JA45AF54CS

Abstract

Giriş: Neoadjuvan tedavi alan rektum kanseri hastalarında D vitamini seviyesi ile patolojik yanıt ve sağkalım arasındaki ilişki, henüz yeterince araştırılmamış bir konudur.
Amaç: Bu popülasyonda D vitamini seviyesi ile patolojik yanıt arasındaki ilişkiyi araştırmayı planladık.
Gereç ve Yöntem: Ocak 2012 ile Mayıs 2023 tarihleri arasında Ankara Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Kliniği'nde rektum kanseri tanısı alan ve takip edilen hastalar çalışmaya dahil edildi. Hastaların demografik verileri, D vitamini seviyesi, evreleri, kemoterapi ve radyoterapi protokolleri, cerrahi tipi ve postoperatif patolojik yanıtları kaydedildi ve istatistiksel olarak karşılaştırıldı.
Bulgular: Çalışmaya 83 hasta dahil edildi. Tanı anında medyan D vitamini seviyesi 15,89 ng/mL idi. Yaşta her 1 yıllık artış, D vitamini seviyelerinde 0,22 ng/mL'lik bir düşüşle ilişkilendirildi. D vitamini seviyesi ile patolojik yanıt arasında anlamlı bir ilişki bulunamadı. Evre 1 hastalığa kıyasla evre 4'te D vitamini seviyeleri 13 ng/mL daha düşük bulundu, ancak fark anlamlı değildi. Nüks ve sağkalım oranları, D vitamini seviyeleri ile anlamlı bir ilişki göstermedi. 60 yaş üzeri hastalar değerlendirildiğinde, ypT0 hastalığa kıyasla ypT4 hastalığı olan hastalarda D vitamini seviyeleri anlamlı olarak daha düşüktü.
Sonuç: D vitamini seviyeleri ile patolojik yanıt arasında anlamlı bir ilişki gösterilemedi. İleri yaş ve daha ileri evre hastalıkta D vitamini seviyelerinin prognoz ve patolojik yanıt üzerindeki etkisini araştırmak için daha fazla çalışmaya ihtiyaç vardır.

Ethical Statement

Bu çalışma Helsinki Deklarasyonu ilkeleri doğrultusunda gerçekleştirilmiştir. Ankara Üniversitesi Etik Kurulu'ndan onay alınmıştır. (31.08.2023/No: 2023000501, 2023/501)

Supporting Institution

Ankara Üniversitesi Tıp Fakültesi

Project Number

31.08.2023/No: 2023000501, 2023/501

Thanks

İç Hastalıkları ve Tıbbi Onkoloji Bölümü ile Genel Cerrahi Bölümü'ne katkılarından dolayı teşekkür ederiz.

References

  • Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–263.
  • Cruz-Pierard SM, Nestares T, Amaro-Gahete FJ. Vitamin D and Calcium as Key Potential Factors Related to Colorectal Cancer Prevention and Treatment: A Systematic Review. Nutrients. 2022;14(22):4934.
  • Hernández-Alonso P, Boughanem H, Canudas S, et al. Circulating vitamin D levels and colorectal cancer risk: A meta-analysis and systematic review of case-control and prospective cohort studies. Crit Rev Food Sci Nutr. 2023;63(1):1–17.
  • Li J, Qin S, Zhang S, et al. Serum vitamin D concentration, vitamin Drelated polymorphisms, and colorectal cancer risk. Int J Cancer. 2023;153(2):278–289.
  • Paulsen EM, Rylander C, Brustad M, et al. Pre-diagnostic intake of vitamin D and incidence of colorectal cancer by anatomical subsites: the Norwegian Women and Cancer Cohort Study (NOWAC). Br J Nutr. 2023;1–9.
  • Wang Q-L, Ma C, Yuan C, et al. Plasma 25-Hydroxyvitamin D Levels and Survival in Stage III Colon Cancer: Findings from CALGB/SWOG 80702 (Alliance). Clin Cancer Res. 2023;29(14):2621–2630.
  • Markotic A, Langer S, Kelava T, et al. Higher Post-Operative Serum Vitamin D Level is Associated with Better Survival Outcome in Colorectal Cancer Patients. Nutr Cancer. 2019;71(7):1078–1085.
  • Song M, Lee I-M, Manson JE, et al. No Association Between Vitamin D Supplementation and Risk of Colorectal Adenomas or Serrated Polyps in a Randomized Trial. Clin Gastroenterol Hepatol. 2021;19(1):128-135.e6.
  • Wesselink E, Kok DE, Bours MJ, et al. Vitamin D, magnesium, calcium, and their interaction in relation to colorectal cancer recurrence and all-cause mortality. Am J Clin Nutr. 2020;111(5):1007–1017.
  • Na S-Y, Kim KB, Lim YJ, et al. Vitamin D and Colorectal Cancer: Current Perspectives and Future Directions. J Cancer Prev. 2022;27(3):147–156.
  • Dou R, Ng K, Giovannucci EL, et al. Vitamin D and colorectal cancer: molecular, epidemiological and clinical evidence. Br J Nutr. 2016;115(9):1643–1660.
  • Gnagnarella P, Raimondi S, Aristarco V, et al. Vitamin D Receptor Polymorphisms and Cancer. 2020. p. 53–114.
  • Giustina A, Bouillon R, Dawson-Hughes B, et al. Vitamin D in the older population: a consensus statement. Endocrine. 2022;79(1):31–44.
  • Maalmi H, Ordóñez-Mena JM, Schöttker B, et al. Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: Systematic review and meta-analysis of prospective cohort studies. Eur J Cancer. 2014;50(8):1510–1521.
  • Huang D, Lei S, Wu Y, et al. Additively protective effects of vitamin D and calcium against colorectal adenoma incidence, malignant transformation and progression: A systematic review and meta-analysis. Clin Nutr. 2020;39(8):2525–2538.

Role of Vitamin D in Patients with Rectum Cancer Receiving Neoadjuvant Treatment

Year 2026, Volume: 79 Issue: 1, 40 - 46, 27.03.2026
https://doi.org/10.65092/autfm.1788633
https://izlik.org/JA45AF54CS

Abstract

Background: Relationship between vitamin D level and pathological response and survival in rectal cancer patients receiving neoadjuvant therapy, is an unstudied issue.
Aim: We planned to investigate the relationship between vitamin D level and pathological response in this population.
Materials and Methods: Patients diagnosed with rectal cancer and followed up at Ankara University Faculty of Medicine, Medical Oncology Clinic between January 2012 and May 2023 were included. Patients' demographic data, vitamin D level, stages, chemotherapy and radiotherapy protocols, type of surgery and postoperative pathological responses were recorded and compared statistically.
Results: Eighty-three patients were included in the study. Median vitamin D level at the time of diagnosis was 15.89 ng/mL. Each 1-year increase in age was associated with a 0.22 ng/mL decrease in vitamin D levels. No significant relationship between vitamin D level and pathological response was found. Vitamin D levels were 13 ng/mL lower in stage 4 compared to stage 1 disease, but the difference was not significant. Relapse and survival rates were not significantly related with Vitamin D levels. When patients over 60 years of age were evaluated, vitamin D levels were significantly lower in patients with ypT4 against ypT0 disease.
Conclusion: No significant relationship could be demonstrated between vitamin D levels and pathological response. More studies are needed to investigate the effect of vitamin D levels on prognosis and pathological response in older age and more advanced disease.

Ethical Statement

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Ankara University. (31.08.2023/No: 2023000501, 2023/501)

Supporting Institution

Ankara University, Faculty of Medicine

Project Number

31.08.2023/No: 2023000501, 2023/501

Thanks

We thank the Internal Medicine and Medical Oncology Department, as well as General Surgery Department for their contributions.

References

  • Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–263.
  • Cruz-Pierard SM, Nestares T, Amaro-Gahete FJ. Vitamin D and Calcium as Key Potential Factors Related to Colorectal Cancer Prevention and Treatment: A Systematic Review. Nutrients. 2022;14(22):4934.
  • Hernández-Alonso P, Boughanem H, Canudas S, et al. Circulating vitamin D levels and colorectal cancer risk: A meta-analysis and systematic review of case-control and prospective cohort studies. Crit Rev Food Sci Nutr. 2023;63(1):1–17.
  • Li J, Qin S, Zhang S, et al. Serum vitamin D concentration, vitamin Drelated polymorphisms, and colorectal cancer risk. Int J Cancer. 2023;153(2):278–289.
  • Paulsen EM, Rylander C, Brustad M, et al. Pre-diagnostic intake of vitamin D and incidence of colorectal cancer by anatomical subsites: the Norwegian Women and Cancer Cohort Study (NOWAC). Br J Nutr. 2023;1–9.
  • Wang Q-L, Ma C, Yuan C, et al. Plasma 25-Hydroxyvitamin D Levels and Survival in Stage III Colon Cancer: Findings from CALGB/SWOG 80702 (Alliance). Clin Cancer Res. 2023;29(14):2621–2630.
  • Markotic A, Langer S, Kelava T, et al. Higher Post-Operative Serum Vitamin D Level is Associated with Better Survival Outcome in Colorectal Cancer Patients. Nutr Cancer. 2019;71(7):1078–1085.
  • Song M, Lee I-M, Manson JE, et al. No Association Between Vitamin D Supplementation and Risk of Colorectal Adenomas or Serrated Polyps in a Randomized Trial. Clin Gastroenterol Hepatol. 2021;19(1):128-135.e6.
  • Wesselink E, Kok DE, Bours MJ, et al. Vitamin D, magnesium, calcium, and their interaction in relation to colorectal cancer recurrence and all-cause mortality. Am J Clin Nutr. 2020;111(5):1007–1017.
  • Na S-Y, Kim KB, Lim YJ, et al. Vitamin D and Colorectal Cancer: Current Perspectives and Future Directions. J Cancer Prev. 2022;27(3):147–156.
  • Dou R, Ng K, Giovannucci EL, et al. Vitamin D and colorectal cancer: molecular, epidemiological and clinical evidence. Br J Nutr. 2016;115(9):1643–1660.
  • Gnagnarella P, Raimondi S, Aristarco V, et al. Vitamin D Receptor Polymorphisms and Cancer. 2020. p. 53–114.
  • Giustina A, Bouillon R, Dawson-Hughes B, et al. Vitamin D in the older population: a consensus statement. Endocrine. 2022;79(1):31–44.
  • Maalmi H, Ordóñez-Mena JM, Schöttker B, et al. Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: Systematic review and meta-analysis of prospective cohort studies. Eur J Cancer. 2014;50(8):1510–1521.
  • Huang D, Lei S, Wu Y, et al. Additively protective effects of vitamin D and calcium against colorectal adenoma incidence, malignant transformation and progression: A systematic review and meta-analysis. Clin Nutr. 2020;39(8):2525–2538.
There are 15 citations in total.

Details

Primary Language English
Subjects Clinical Oncology
Journal Section Research Article
Authors

Merih Yalçıner 0000-0003-3337-2188

Çağla Tezduyan 0000-0002-2534-6425

Efe Cem Erdat 0000-0002-1250-1297

Mehmet Ayhan Kuzu 0000-0003-1561-9060

Cihangir Akyol 0000-0002-3941-5268

Güngör Utkan 0000-0001-8445-6993

Project Number 31.08.2023/No: 2023000501, 2023/501
Submission Date September 22, 2025
Acceptance Date January 27, 2026
Publication Date March 27, 2026
DOI https://doi.org/10.65092/autfm.1788633
IZ https://izlik.org/JA45AF54CS
Published in Issue Year 2026 Volume: 79 Issue: 1

Cite

APA Yalçıner, M., Tezduyan, Ç., Erdat, E. C., Kuzu, M. A., Akyol, C., & Utkan, G. (2026). Role of Vitamin D in Patients with Rectum Cancer Receiving Neoadjuvant Treatment. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 79(1), 40-46. https://doi.org/10.65092/autfm.1788633
AMA 1.Yalçıner M, Tezduyan Ç, Erdat EC, Kuzu MA, Akyol C, Utkan G. Role of Vitamin D in Patients with Rectum Cancer Receiving Neoadjuvant Treatment. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2026;79(1):40-46. doi:10.65092/autfm.1788633
Chicago Yalçıner, Merih, Çağla Tezduyan, Efe Cem Erdat, Mehmet Ayhan Kuzu, Cihangir Akyol, and Güngör Utkan. 2026. “Role of Vitamin D in Patients With Rectum Cancer Receiving Neoadjuvant Treatment”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 79 (1): 40-46. https://doi.org/10.65092/autfm.1788633.
EndNote Yalçıner M, Tezduyan Ç, Erdat EC, Kuzu MA, Akyol C, Utkan G (March 1, 2026) Role of Vitamin D in Patients with Rectum Cancer Receiving Neoadjuvant Treatment. Ankara Üniversitesi Tıp Fakültesi Mecmuası 79 1 40–46.
IEEE [1]M. Yalçıner, Ç. Tezduyan, E. C. Erdat, M. A. Kuzu, C. Akyol, and G. Utkan, “Role of Vitamin D in Patients with Rectum Cancer Receiving Neoadjuvant Treatment”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 79, no. 1, pp. 40–46, Mar. 2026, doi: 10.65092/autfm.1788633.
ISNAD Yalçıner, Merih - Tezduyan, Çağla - Erdat, Efe Cem - Kuzu, Mehmet Ayhan - Akyol, Cihangir - Utkan, Güngör. “Role of Vitamin D in Patients With Rectum Cancer Receiving Neoadjuvant Treatment”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 79/1 (March 1, 2026): 40-46. https://doi.org/10.65092/autfm.1788633.
JAMA 1.Yalçıner M, Tezduyan Ç, Erdat EC, Kuzu MA, Akyol C, Utkan G. Role of Vitamin D in Patients with Rectum Cancer Receiving Neoadjuvant Treatment. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2026;79:40–46.
MLA Yalçıner, Merih, et al. “Role of Vitamin D in Patients With Rectum Cancer Receiving Neoadjuvant Treatment”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 79, no. 1, Mar. 2026, pp. 40-46, doi:10.65092/autfm.1788633.
Vancouver 1.Merih Yalçıner, Çağla Tezduyan, Efe Cem Erdat, Mehmet Ayhan Kuzu, Cihangir Akyol, Güngör Utkan. Role of Vitamin D in Patients with Rectum Cancer Receiving Neoadjuvant Treatment. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2026 Mar. 1;79(1):40-6. doi:10.65092/autfm.1788633