Conflict of interest
Vitamin D deficiency is associated with greater tumor size and poorer outcome in Merkel cell carcinoma patients
Article first published online: 1 FEB 2013
© 2013 The Authors Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 28, Issue 3, pages 298–308, March 2014
How to Cite
Samimi, M., Touzé, A., Laude, H., Le Bidre, E., Arnold, F., Carpentier, A., Gardair, C., Carlotti, A., Maubec, E., Dupin, N., Aubin, F., Avril, M.F., Rozenberg, F., Avenel-Audran, M., Guyetant, S., Lorette, G., Machet, L. and Coursaget, P. (2014), 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, 28: 298–308. doi: 10.1111/jdv.12101
- Issue published online: 19 FEB 2014
- Article first published online: 1 FEB 2013
- Manuscript Accepted: 20 DEC 2012
- Manuscript Received: 24 OCT 2012
- Ligue Contre le Cancer
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.
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.
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.
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.
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.