Role of vitamin D serum levels in prevention of primary and recurrent melanoma

Abstract

Patients afflicted with melanoma show lower vitamin D serum levels (VDSL) than the healthy population. This hypothesis agrees with its well-known antiproliferative features. An observational study was carried out to collect VDSL in patients suffering from melanoma. Our aim was to identify a potential connection between low VDSL and the risk to incur melanoma. Furthermore, we studied the association between VDSL at the diagnosis of melanoma and other germane prognostic factors. The population held in regard was composed of 154 patients with a diagnosis of melanoma between 2016 and 2019. These patients were retrospectively collected from our follow-up storage. We compared VDSL to clinical and pathological parameters (age, sex, tumour location, Breslow’s depth, Clark’s level, histological subtype, ulceration, et aliqua). Moreover, we recruited a control group with negative melanoma history. Mean and median of VDSL were significantly lower in the melanoma group. Instead, we found a negative association between melanoma and VDSL > 30 ng/L (OR 0.11; p < 0.0001). No correlation between VDSL and both Breslow’s depth and Clark’s level was discovered, but the VDSL comparison between thin (depth ≤ 1 mm) and thick tumours (depth > 1 mm) revealed a statistically significant difference (21.1 ± 8.2 ng/L vs 17.8 ± 8.1; p = 0.01). Moreover, VDSL were significantly lower in melanomas with mitotic rate ≥ 1/mm2 (22.1 ± 8.3 ng/L; p < 0007). Nevertheless, no connection was found between VDSL and both ulceration and positive sentinel nodes (p = 0.76; p = 0.74). Besides, our study revealed no association between VDSL and histological subtype (p = 0.161). Lower VDSL correlate with thick and high mitotic rate tumours. Future prospective studies would investigate if appropriate upkeep of suitable VDSL can decrease the risk of primary and recurrent melanoma diagnosis.

Determinants of 25-hydroxyvitamin D Status in a Cutaneous Melanoma Population

“…Univariate analysis demonstrated a statistically significant association between higher tumour stage and lower 25OHD levels, in line with previous studies ( 16 , 17 , 35 , 36 ). We found no significant correlation between 25OHD level and histological subtype of primary tumour tissue, Clark level, mitosis, vascular invasion, perineural invasion, regression, or TILs.…”

Vitamin D insufficiency and serum levels related to the incidence and stage of cutaneous melanoma: a systematic review and meta-analysis

“…After removing duplicate and irrelevant studies, 115 studies met the criteria for full-text review. Fourteen studies met inclusion criteria and were evaluated for data extraction and inclusion in our statistical analysis [10][11][12][13][14][15][16][17][18][19][20]23,31,32]. One study was excluded from our meta-analysis due to incomplete reporting of SD [17].…”

“…Employing a random effects model, we performed a meta-analysis on eight studies, including 1895 patients, which reported data on mean 25(OH)D level and the incidence of CM [10][11][12][13][14][15]31,32]. The effect size is the SMD, and the pooled effect size shows that 25(OH)D levels tend to be lower in those diagnosed with CM (mean 22.85 ng/ ml) compared to those without CM (mean 23.70 ng/ml) with a pooled SMD of −0.39, (95% CI, −0.80 to 0.01), so the effect does not reach significance (Fig.…”

“…Since vitamin D receptors are widely expressed in melanocytes, the relationship between this prodrug and skin cancers has been a topic of research [8,9]. There is increasing data to suggest that vitamin D insufficiency is a risk factor for melanoma incidence and mortality, and that vitamin D sufficiency may have more protective effects [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Two systematic reviews and meta-analyses have showed a direct correlation between higher serum vitamin D levels and thinner Breslow tumor thickness at the time of diagnosis of CM [25,26].…”

Altitude Effect on Cutaneous Melanoma Epidemiology in the Veneto Region (Northern Italy): A Pilot Study

“…It may also be related to the lower vitamin D levels of people living at higher altitude due to reduced chronic sun exposure and a different diet. Low vitamin D seems to be associated to a more aggressive biology of cancer and to a high number of mitoses [ 30 , 31 , 32 , 33 ]. When assessing the potential prognostic role of altitude, we found no significant survival differences among patients living in different geographical areas of the Veneto Region, while clinically relevant factors (such as higher Breslow, presence of ulceration, higher number of mitoses per mm 2 and pTNM III-IV) were confirmed as risk factors for survival.…”