Kolorektal Kanser Hastalarında Serum Vitamin D Düzeylerinin Hayatta Kalma Sonuçları Üzerindeki Prognostik Etkisi

Abstract

Arka Plan: Düşük serum D vitamini düzeyleri, kolorektal kanserde (CRC) artmış risk ve daha kötü prognoz ile ilişkilendirilmiştir. Bu çalışmada, tanı anındaki D vitamini düzeylerinin ve D vitamini replasmanının CRC hastalarında genel sağkalım üzerindeki etkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu retrospektif çalışmada, Ocak 2012–Aralık 2021 tarihleri arasında üçüncü basamak bir onkoloji merkezinde tedavi ve takip edilen 243 CRC hastası analiz edilmiştir. Klinik ve patolojik özellikler, tedavi ayrıntıları, tanı anındaki D vitamini düzeyleri ve D vitamini replasman durumu tıbbi kayıtlardan elde edilmiştir. Bulgular: Tanı anında 190 hastada düşük, 53 hastada ise normal D vitamini düzeyleri saptanmıştır. Verilerine ulaşılan 239 hastanın 91’i D vitamini replasmanı alırken, 148’i almamıştır. Başlangıç D vitamini düzeyleri genel sağkalım ile istatistiksel olarak anlamlı ilişki göstermemekle birlikte (p = 0.110), daha yüksek D vitamini düzeylerine sahip hastalarda medyan sağkalım daha uzun bulunmuştur. D vitamini replasmanı alan hastalarda sağkalım anlamlı düzeyde daha iyi saptanmıştır (p = 0.001). Evreye göre medyan sağkalım; evre I–II için 112.2 ay (%95 GA: 94.5–130.0), evre III için 86.5 ay (GA: 70.5–102.4) ve evre IV için 51.4 ay (GA: 39.6–63.3) olarak belirlenmiştir. D vitamini replasmanının tüm evrelerde sağkalımı iyileştirdiği, en belirgin etkinin metastatik olmayan hastalarda görüldüğü izlenmiştir. Sonuç: D vitamini replasmanı, özellikle adjuvan kemoterapi ile birlikte uygulandığında, CRC’de sağkalım sonuçlarını iyileştiriyor gibi görünmektedir. Bu bulgular, D vitamininin CRC tedavi protokollerinde tamamlayıcı bir bileşen olarak potansiyel rolünü desteklemektedir

Keywords

• kolorektal kanser
• d vitamini
• genel sağkalım

Prognostic Impact of Serum Vitamin D Levels on Survival Outcomes in Colorectal Cancer Patients

Abstract

Background: Low serum vitamin D levels have been linked to increased risk and poorer prognosis in colorectal cancer (CRC). This study aimed to evaluate the impact of baseline vitamin D levels and supplementation on overall survival in CRC patients. Method: In this retrospective study, 243 CRC patients treated and followed at a tertiary oncology center between January 2012 and December 2021 were analyzed. Clinical and pathological features, treatment details, vitamin D levels at diagnosis, and supplementation status were collected from medical records. Result: At diagnosis, 190 patients had low vitamin D levels, and 53 had normal levels. Among 239 patients with available data, 91 received vitamin D supplementation, while 148 did not. Although baseline vitamin D levels were not significantly associated with overall survival (p = 0.110), patients with higher levels had longer median survival. Patients receiving supplementation demonstrated significantly better survival (p = 0.001). Median survival by stage was 112.2 months (95% CI: 94.5–130.0) for stages I–II, 86.5 months (CI: 70.5–102.4) for stage III, and 51.4 months (CI: 39.6–63.3) for stage IV. Supplementation improved survival across all stages, with the most pronounced effect in non-metastatic patients. Conclusion: Vitamin D supplementation appears to enhance survival outcomes in CRC, especially when combined with adjuvant chemotherapy. These findings support the potential role of vitamin D as a complementary component of CRC treatment protocols.

Keywords

• colorectal cancer
• vitamin d
• overall survival

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