MS O03 - HPB Vitamin D deficiency and Survival in Pancreatic Ductal Adenocarcinoma Patients Who Received Adjuvant Chemotherapy

Abstract Background It is proposed that vitamin D contributes to reducing inflammation and tumour size by binding to vitamin D receptors (VDR) of pancreatic cancer cells, which activates response pathway thus enhancing delivery of intracellular chemotherapy. As vitamin D is a fat-soluble vitamin, individuals with pancreatic ductal adenocarcinoma (PDAC) are at risk of being vitamin D deficient due to the high prevalence of pancreatic exocrine insufficiency (PEI). We investigated the relationship between vitamin D deficiency and survival outcomes of patients with PDAC. Method Patients who had resected PDAC at Queen Elizabeth Hospital Birmingham between 2014-2020 were reviewed. Patients who died within 90 days of the operation were excluded. Patient demographics, pre-operative vitamin D levels, adjuvant chemotherapy (AC) details and survival outcomes were collected. Vitamin D deficiency was defined as the serum 25-hydroxyvitamin D (25(OH)D) level of less than 25 nmol/L. Results 202 patients were identified, of whom 63 (31%) were vitamin D deficient. Among 151 patients who received AC, 48 (32%) were vitamin D deficient. Patient demographics were comparable between the AC and non-AC groups, except age, which was higher in the non-AC group (p<0.01)(Table 1). OS and DFS were significantly reduced in patients with vitamin D deficiency compared to those with sufficient vitamin D levels (p< 0.05). This trend was also observed in the AC subgroup. However, no significant differences in OS and DFS were found between vitamin D deficient and sufficient patients in the non-AC subgroup (Table 2). Conclusion Vitamin D deficiency is associated with lower OS and DFS, particularly in patients receiving adjuvant chemotherapy (AC). The greater survival outcomes observed in the AC group suggests that vitamin D enhances chemotherapy efficacy. Further studies are required to explore the cellular interactions between vitamin D and PDAC.