Research Papers:

Vitamin D deficiency is associated with a worse prognosis in metastatic melanoma

Dmitriy Timerman _, Melissa McEnery-Stonelake, Cara J. Joyce, Vinod E. Nambudiri, F. Stephen Hodi, Elizabeth B. Claus, Nageatte Ibrahim and Jennifer Y. Lin

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Oncotarget. 2017; 8:6873-6882. https://doi.org/10.18632/oncotarget.14316

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Dmitriy Timerman1, Melissa McEnery-Stonelake2, Cara J. Joyce3, Vinod E. Nambudiri4, F. Stephen Hodi5, Elizabeth B. Claus6, Nageatte Ibrahim5,7 Jennifer Y. Lin4,5

1Harvard-MIT Health Sciences and Technology (HST), Harvard Medical School, Boston, MA, USA

2Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA

3Department of Biostatistics, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

4Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

5Melanoma Program, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

6Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

7Merck Research Laboratories, Clinical Oncology, North Wales, PA, USA

Correspondence to:

Jennifer Y. Lin, email: [email protected]

Keywords: vitamin D deficiency, melanoma, 25(OH)D3

Received: June 20, 2016     Accepted: December 05, 2016     Published: December 28, 2016


Vitamin D deficiency (≤20 ng/mL) is associated with an increased incidence and worse prognosis of various types of cancer including melanoma. A retrospective, single-center study of individuals diagnosed with melanoma from January 2007 through June 2013 who had a vitamin D (25(OH)D3) level measured within one year of diagnosis was performed to determine whether vitamin D deficiency and repletion are associated with melanoma outcome. A total of 409 individuals diagnosed with histopathology-confirmed melanoma who had an ever measured serum 25(OH)D3 level were identified. 252 individuals with a 25(OH)D3 level recorded within one year after diagnosis were included in the study and the individual and melanoma characteristics such as age, sex, Breslow thickness, ulceration, stage, mitotic rate, and LDH were obtained from the medical record. A worse melanoma prognosis was associated with vitamin D deficiency (P=0.012), higher stage (P<0.001), ulceration (P=0.001), and higher mitotic rate (P=0.001) (HR 1.93, 95% CI 1.15-3.22). In patients with stage IV metastatic melanoma, vitamin D deficiency was associated with significantly worse melanoma-specific mortality (adjusted HR 2.06, 95% CI 1.10-3.87). Patients with metastatic melanoma who were initially vitamin D deficient and subsequently had a decrease or ≤20 ng/mL increase in their 25(OH)D3 concentration had significantly worse outcomes (HR 4.68, 95% CI 1.05-20.88) compared to non-deficient patients who had a >20 ng/mL increase. Our results suggest that initial vitamin D deficiency and insufficient repletion is associated with a worse prognosis in patients with metastatic melanoma.

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