Some coauthors of this study previously performed the AMATERASU randomized,\ndouble-blind, placebo-controlled trial of postoperative oral vitamin D supplementation (2000 IU/day)\nin 417 patients with stage I to III digestive tract cancer fromthe esophagus to the rectum who underwent\ncurative surgery (UMIN000001977). We conducted a post-hoc analysis of the AMATERASU trial to\nexplore the effects of modification of vitaminDsupplementation by histopathological characteristics on\nsurvival. Among patients with poorly differentiated adenocarcinoma, the 5-year relapse-free survival\nrate of patients supplemented with vitamin D was 91% compared with 63% in the placebo group (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.08 to 0.78; P = 0.017; P for interacti\nSimilarly, the 5-year overall survival rate was 92% in the vitamin D group compared with 72% in the placebo group (HR, 0.25; 95%CI, 0.07 to 0.94; P = 0.040; P for interacti In contrast,\nthere were no significant effects in other histopathological characteristics between vitamin D and\nplacebo groups. These findings generated the hypothesis that oral vitamin D supplementation\nmay improve both relapse-free survival and overall survival in a subgroup of patients with poorly\ndifferentiated adenocarcinoma.
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