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Merkel cell carcinoma (a rare skin cancer) recurrence 3X more likely if low vitamin D – Feb 2013

Vitamin D deficiency is associated with greater tumor size and poorer outcome in Merkel cell carcinoma patients

Journal of the European Academy of Dermatology and Venereology
M. Samimi1,2,3,*, A. Touzé1,2, H. Laude4,5, E. Le Bidre3,6, F. Arnold1,2, A. Carpentier1,2,
C. Gardair2,7, A. Carlotti4,5, E. Maubec8, N. Dupin4,5, F. Aubin9, M.F. Avril4,5,
F. Rozenberg4,5, M. Avenel-Audran10, S. Guyetant2,7, G. Lorette1,2,3, L. Machet2,3, P. Coursaget1,2

Merkel cell polyomavirus has been recognized to be associated with Merkel cell carcinoma (MCC), but the evolution of this cancer probably depends on various factors. Vitamin D deficiency, defined by serum 25-hydroxyvitamin D levels <50 nmol/L, seems to influence cancer behavior and progression, but has never been assessed in MCC patients.

Objectives:First, to evaluate whether vitamin D deficiency was associated with tumor characteristics and prognosis in a cohort of MCC patients. Second, to assess expression of the vitamin D receptor (VDR) in MCC tumors.

Methods: Clinical findings, Merkel cell polyomavirus markers and vitamin D status were assessed in a cohort of French MCC patients. The study was limited to the 89 patients for whom the serum sample had been collected within 3 years after the diagnosis of MCC. Correlation between vitamin D deficiency and MCC characteristics and outcome were determined in regression analyses. VDR expression in MCC tumours was assessed by immunohistochemistry.

Results” Vitamin D deficiency was noted in 65.1% of the patients and was independently associated with greater tumor size at diagnosis (P = 0.006) and with metastasis recurrence (HR, 2.89; 95% CI, 1.03 to 8.13; P = 0.043), but not with death from MCC, although there was a trend (HR, 5.28; 95% CI, 0.75 to 36.96; P = 0.093). VDR was found to be strongly expressed in all 28 MCC tumor specimens investigated.

Conclusion: The association between vitamin D deficiency and MCC characteristics and outcome, together with detection of the VDR in MCC cells, suggest that vitamin D could influence the biology of MCC.


Vitamin D deficiency is associated with greater tumor size and poorer outcome in Merkel cell carcinoma patients Feb 2013

Results
Vitamin D deficiency was noted in 65.1% of the patients and was independently associated with

+greater tumor size at diagnosis (P = 0.006) and with

_metastasis recurrence (HR, 2.89; 95% CI, 1.03 to 8.13; P = 0.043),

+but not with death from MCC, +although there was a trend (HR, 5.28; 95% CI, 0.75 to 36.96; P = 0.093). VDR was found to be strongly expressed in all 28 MCC tumor specimens investigated.

Rare: 1,500 new cases of MCC diagnosed annually in US, vs 60,000 new melanoma

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