1. Higher vitamin B6 status is associated with improved survival among patients with stage I-III colorectal cancer
- Author
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Holowatyj, A.N., Ose, J., Gigic, B., Lin, T., Ulvik, A., Geijsen, A, Brezina, S., Kiblawi, R., Roekel, E.H. van, Baierl, A., Böhm, J., Bours, M.J., Brenner, H., Breukink, S.O., Chang-Claude, J., Wilt, J.H.W. de, Grady, W.M., Grünberger, T., Gumpenberger, T., Herpel, E., Hoffmeister, M., Keulen, E.T.P., Kok, D.E., Koole, J.L., Kosma, K., Kouwenhoven, E.A., Kvalheim, G., Li, C.I., Schirmacher, P., Schrotz-King, P., Singer, M.C., Duijnhoven, F. J. B. van, Halteren, H.K. van, Vickers, K., Vogelaar, F.J., Warby, C.A., Wesselink, E., Ueland, P.M., Ulrich, A.B., Schneider, M., Habermann, N., Kampman, E., Weijenberg, M.P., Gsur, A., Ulrich, C.M., Holowatyj, A.N., Ose, J., Gigic, B., Lin, T., Ulvik, A., Geijsen, A, Brezina, S., Kiblawi, R., Roekel, E.H. van, Baierl, A., Böhm, J., Bours, M.J., Brenner, H., Breukink, S.O., Chang-Claude, J., Wilt, J.H.W. de, Grady, W.M., Grünberger, T., Gumpenberger, T., Herpel, E., Hoffmeister, M., Keulen, E.T.P., Kok, D.E., Koole, J.L., Kosma, K., Kouwenhoven, E.A., Kvalheim, G., Li, C.I., Schirmacher, P., Schrotz-King, P., Singer, M.C., Duijnhoven, F. J. B. van, Halteren, H.K. van, Vickers, K., Vogelaar, F.J., Warby, C.A., Wesselink, E., Ueland, P.M., Ulrich, A.B., Schneider, M., Habermann, N., Kampman, E., Weijenberg, M.P., Gsur, A., and Ulrich, C.M.
- Abstract
Item does not contain fulltext, BACKGROUND: Folate-mediated 1-carbon metabolism requires several nutrients, including vitamin B6. Circulating biomarker concentrations indicating high vitamin B6 status are associated with a reduced risk of colorectal cancer (CRC). However, little is known about the effect of B6 status in relation to clinical outcomes in CRC patients. 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.
- Published
- 2022