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@ARTICLE{Holowatyj:180076,
      author       = {A. N. Holowatyj and J. Ose and B. Gigic and T. Lin and A.
                      Ulvik and A. J. M. R. Geijsen and S. Brezina and R. Kiblawi
                      and E. H. van Roekel and A. Baierl and J. Böhm and M. J. L.
                      Bours and H. Brenner$^*$ and S. O. Breukink and J.
                      Chang-Claude$^*$ and J. H. W. de Wilt and W. M. Grady and T.
                      Grünberger and T. Gumpenberger and E. Herpel and M.
                      Hoffmeister$^*$ and E. T. P. Keulen and D. E. Kok and J. L.
                      Koole and K. Kosma and E. A. Kouwenhoven and G. Kvalheim and
                      C. I. Li and P. Schirmacher and P. Schrotz-King$^*$ and M.
                      C. Singer and F. J. B. van Duijnhoven and H. K. van Halteren
                      and K. Vickers and F. J. Vogelaar and C. A. Warby and E.
                      Wesselink and P. M. Ueland and A. B. Ulrich and M. Schneider
                      and N. Habermann and E. Kampman and M. P. Weijenberg and A.
                      Gsur and C. M. Ulrich},
      title        = {{H}igher vitamin {B}6 status is associated with improved
                      survival among patients with stage {I}-{III} colorectal
                      cancer.},
      journal      = {The American journal of clinical nutrition},
      volume       = {116},
      number       = {2},
      issn         = {0002-9165},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2022-01075},
      pages        = {303-313},
      year         = {2022},
      note         = {2022 Aug 4;116(2):303-313},
      abstract     = {Folate-mediated one-carbon metabolism requires several
                      nutrients, including vitamin B6. Circulating levels of
                      biomarkers 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.We investigated survival
                      outcomes in relation to vitamin B6 status in prospectively
                      followed CRC patients.A total of 2031 patients with stage
                      I-III CRC participated in six prospective patient cohorts in
                      the international FOCUS Consortium. Preoperative blood
                      samples were used to measure vitamin B6 status by the direct
                      marker pyridoxal 5'-phosphate, PLP, as well as functional
                      marker the HK-ratio (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 levels, tumor site, stage, and cohort.After a
                      median follow-up of 3.2 years 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: hazard ratio, 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).Higher preoperative vitamin B6 status is
                      associated with improved OS among stage I-III CRC patients.},
      keywords     = {HKr (Other) / PAR (Other) / PLP (Other) / cancer (Other) /
                      colon cancer (Other) / colorectal cancer (Other) / mortality
                      (Other) / one-carbon metabolism (Other) / rectal cancer
                      (Other) / recurrence (Other) / survival (Other) /
                      survivorship (Other) / vitamin b6 (Other) / vitamins
                      (Other)},
      cin          = {C070 / C120 / HD01 / C020},
      ddc          = {570},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35394006},
      doi          = {10.1093/ajcn/nqac090},
      url          = {https://inrepo02.dkfz.de/record/180076},
}