Higher vitamin B6 status is associated with improved survival among patients with stage I-III colorectal cancer.
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Holowatyj Andreana N, Ose Jennifer, Gigic Biljana, Lin Tengda, Ulvik Arve, Geijsen Anne J M R, Brezina Stefanie, Kiblawi Rama, van Roekel Eline H, Baierl Andreas, Böhm Jürgen, Bours Martijn J L, Brenner Hermann, Breukink Stéphanie O, Chang-Claude Jenny, de Wilt Johannes H W, Grady William M, Grünberger Thomas, Gumpenberger Tanja, Herpel Esther, Hoffmeister Michael, Keulen Eric T P, Kok Dieuwertje E, Koole Janna L, Kosma Katharina, Kouwenhoven Ewout A, Kvalheim Gry, Li Christopher I, Schirmacher Peter, Schrotz-King Petra, Singer Marie C, van Duijnhoven Fränzel J B, van Halteren Henk K, Vickers Kathy, Vogelaar F Jeroen, Warby Christy A, Wesselink Evertine, Ueland Per M, Ulrich Alexis B, Schneider Martin, Habermann Nina, Kampman Ellen, Weijenberg Matty P, Gsur Andrea, Ulrich Cornelia M
Аннотация
OBJECTIVES: We investigated survival outcomes in relation to vitamin B6 status in prospectively followed CRC patients.
METHODS: A total of 2031 patients with stage I-III CRC participated in 6 prospective patient cohorts in the international FOCUS (folate-dependent 1-carbon metabolism in colorectal cancer recurrence and survival) Consortium. Preoperative blood samples were used to measure vitamin B6 status by the direct marker pyridoxal 5'-phosphate (PLP), as well as the functional marker HK-ratio (HKr)[3'-hydroxykynurenine: (kynurenic acid + xanthurenic acid + 3'-hydroxy anthranilic acid + anthranilic acid)]. Using Cox proportional hazards regression, we examined associations of vitamin B6 status with overall survival (OS), disease-free survival (DFS), and risk of recurrence, adjusted for patient age, sex, circulating creatinine concentrations, tumor site, stage, and cohort.
RESULTS: After a median follow-up of 3.2 y for OS, higher preoperative vitamin B6 status as assessed by PLP and the functional marker HKr was associated with 16-32% higher all-cause and disease-free survival, although there was no significant association with disease recurrence (doubling in PLP concentration: HROS, 0.68; 95% CI: 0.59, 0.79; HRDFS, 0.84; 95% CI: 0.75, 0.94; HRRecurrence, 0.96; 95% CI: 0.84, 1.09; HKr: HROS, 2.04; 95% CI: 1.67, 2.49; HRDFS, 1.56; 95% CI: 1.31, 1.85; HRRecurrence, 1.21; 95% CI: 0.96,1. 52). The association of PLP with improved OS was consistent across colorectal tumor site (right-sided colon: HROS, 0.75; 95% CI: 0.59, 0.96; left-sided colon: HROS, 0.71; 95% CI: 0.55, 0.92; rectosigmoid junction and rectum: HROS, 0.61; 95% CI: 0.47, 0.78).
CONCLUSION: Higher preoperative vitamin B6 status is associated with improved OS among stage I-III CRC patients.