Dose response of retinol and isotretinoin in the prevention of nonmelanoma skin cancer recurrence

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Abstract

Using data from a randomized, double blind, study of the efficacy of retinol or isotretinoin vs. placebo on recurrence of nonmelanoma skin cancer in high-risk subjects, a reanalysis of the original intent to treat analysis was performed in a dose-response format. Cox proportional hazards models describe the relationship between dose quartiles of isotretinoin and retinol use and time to first occurrence of squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) in crude and adjusted models. Neither the isotretinoin nor retinol models showed any significance at any quartile for reduction in first BCC or SCC occurrence. Crude and adjusted retinol models show a statistically significant increase in risk of developing an SCC in the first quartile, whereas only the crude model shows a statistically significant increase in risk in the first quartile of the isotretinoin model. For retinol and SCC, hazard ratios (HRs) for the first quartile were as follows: HR= 2.92, 95% confidence interval (CI)= 1.67-5.10 crude; HR= 1.95, 95% CI= 1.00-3.80 adjusted. For isotretinoin and SCC, HRs for the first quartile were as follows: HR= 2.38, 95% CI= 1.35-4.19 crude; HR= 1.69, 95% CI= 0.87-3.31 adjusted. Test for trend was not significant in any of the models. These analyses confirm the results of the original intent to treat analyses and raise an interesting question related to the potential for increased risk for patients in the first quartile of retinol dose.

Original languageEnglish (US)
Pages (from-to)1058-1066
Number of pages9
JournalNutrition and Cancer
Volume62
Issue number8
DOIs
StatePublished - Nov 2010

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Isotretinoin
Skin Neoplasms
Vitamin A
Squamous Cell Carcinoma
Recurrence
Confidence Intervals
Basal Cell Carcinoma
Proportional Hazards Models
Double-Blind Method
Placebos

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Oncology
  • Cancer Research

Cite this

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title = "Dose response of retinol and isotretinoin in the prevention of nonmelanoma skin cancer recurrence",
abstract = "Using data from a randomized, double blind, study of the efficacy of retinol or isotretinoin vs. placebo on recurrence of nonmelanoma skin cancer in high-risk subjects, a reanalysis of the original intent to treat analysis was performed in a dose-response format. Cox proportional hazards models describe the relationship between dose quartiles of isotretinoin and retinol use and time to first occurrence of squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) in crude and adjusted models. Neither the isotretinoin nor retinol models showed any significance at any quartile for reduction in first BCC or SCC occurrence. Crude and adjusted retinol models show a statistically significant increase in risk of developing an SCC in the first quartile, whereas only the crude model shows a statistically significant increase in risk in the first quartile of the isotretinoin model. For retinol and SCC, hazard ratios (HRs) for the first quartile were as follows: HR= 2.92, 95{\%} confidence interval (CI)= 1.67-5.10 crude; HR= 1.95, 95{\%} CI= 1.00-3.80 adjusted. For isotretinoin and SCC, HRs for the first quartile were as follows: HR= 2.38, 95{\%} CI= 1.35-4.19 crude; HR= 1.69, 95{\%} CI= 0.87-3.31 adjusted. Test for trend was not significant in any of the models. These analyses confirm the results of the original intent to treat analyses and raise an interesting question related to the potential for increased risk for patients in the first quartile of retinol dose.",
author = "Clouser, {Mary C.} and Denise Roe and Foote, {Janet A} and Harris, {Robin B} and Alberts, {David S}",
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T1 - Dose response of retinol and isotretinoin in the prevention of nonmelanoma skin cancer recurrence

AU - Clouser, Mary C.

AU - Roe, Denise

AU - Foote, Janet A

AU - Harris, Robin B

AU - Alberts, David S

PY - 2010/11

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N2 - Using data from a randomized, double blind, study of the efficacy of retinol or isotretinoin vs. placebo on recurrence of nonmelanoma skin cancer in high-risk subjects, a reanalysis of the original intent to treat analysis was performed in a dose-response format. Cox proportional hazards models describe the relationship between dose quartiles of isotretinoin and retinol use and time to first occurrence of squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) in crude and adjusted models. Neither the isotretinoin nor retinol models showed any significance at any quartile for reduction in first BCC or SCC occurrence. Crude and adjusted retinol models show a statistically significant increase in risk of developing an SCC in the first quartile, whereas only the crude model shows a statistically significant increase in risk in the first quartile of the isotretinoin model. For retinol and SCC, hazard ratios (HRs) for the first quartile were as follows: HR= 2.92, 95% confidence interval (CI)= 1.67-5.10 crude; HR= 1.95, 95% CI= 1.00-3.80 adjusted. For isotretinoin and SCC, HRs for the first quartile were as follows: HR= 2.38, 95% CI= 1.35-4.19 crude; HR= 1.69, 95% CI= 0.87-3.31 adjusted. Test for trend was not significant in any of the models. These analyses confirm the results of the original intent to treat analyses and raise an interesting question related to the potential for increased risk for patients in the first quartile of retinol dose.

AB - Using data from a randomized, double blind, study of the efficacy of retinol or isotretinoin vs. placebo on recurrence of nonmelanoma skin cancer in high-risk subjects, a reanalysis of the original intent to treat analysis was performed in a dose-response format. Cox proportional hazards models describe the relationship between dose quartiles of isotretinoin and retinol use and time to first occurrence of squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) in crude and adjusted models. Neither the isotretinoin nor retinol models showed any significance at any quartile for reduction in first BCC or SCC occurrence. Crude and adjusted retinol models show a statistically significant increase in risk of developing an SCC in the first quartile, whereas only the crude model shows a statistically significant increase in risk in the first quartile of the isotretinoin model. For retinol and SCC, hazard ratios (HRs) for the first quartile were as follows: HR= 2.92, 95% confidence interval (CI)= 1.67-5.10 crude; HR= 1.95, 95% CI= 1.00-3.80 adjusted. For isotretinoin and SCC, HRs for the first quartile were as follows: HR= 2.38, 95% CI= 1.35-4.19 crude; HR= 1.69, 95% CI= 0.87-3.31 adjusted. Test for trend was not significant in any of the models. These analyses confirm the results of the original intent to treat analyses and raise an interesting question related to the potential for increased risk for patients in the first quartile of retinol dose.

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