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Lener 1, Wojciech Marciniak 2, Sandra Pietrzak 1, Râa Derkacz 2,  \nCezary Cybulski 1,2, Jacek Gronwald 1,2, Tadeusz D˛ebniak 1, Anna Jakubowska 1, Tomasz Huzarski 1,2,3, Milena Matuszczak 1, Katherine Pullella 4,5, Ping Sun 5 and Steven A. Narod 5,6  \nCitation: Lubi ´nski, J.; Lener, M.R.; Marciniak, W.; Pietrzak, S.; Derkacz, R.; Cybulski, C.; Gronwald, J.; D˛ebniak, T.; Jakubowska, A.; Huzarski, T.; et al. Serum Essential Elements and Survival after Cancer Diagnosis. Nutrients 2023, 15, 2611 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)nu15112611  \nAcademic Editor: Melissa Melough  \nReceived: 21 April 2023  \nRevised: 30 May 2023  \nAccepted: 31 May 2023  \nPublished: 2 June 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; [marcin.lener@pum.edu.pl](marcin.lener@pum.edu.pl) (M.R.L.); [sandra.pietrzak@pum.edu.pl](sandra.pietrzak@pum.edu.pl) (S.P.); [cezary.cybulski@pum.edu.pl](cezary.cybulski@pum.edu.pl) (C.C.); [jgron@pum.edu.pl](jgron@pum.edu.pl) (J.G.); [debniak@pum.edu.pl](debniak@pum.edu.pl) (T.D.); [aniaj@pum.edu.pl](aniaj@pum.edu.pl) (A.J.); [huzarski@pum.edu.pl](huzarski@pum.edu.pl) (T.H.); [matuszczakmilena@gmail.com](matuszczakmilena@gmail.com) (M.M.)  \n2 Read-Gene, Grzepnica, ul. Alabastrowa 8, 72-003 Dobra (Szczeci ´nska), Poland; [wojciech.marciniak@read-gene.com](wojciech.marciniak@read-gene.com) (W.M.); [roza.derkacz@gmail.com](roza.derkacz@gmail.com) (R.D.)  \n3 Department of Clinical Genetics and Pathology, University of Zielona Gâra, ul. Zyty 28, 65-046 Zielona Gâra, Poland  \n4 Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada; [katherine.pullella@mail.utoronto.ca](katherine.pullella@mail.utoronto.ca)  \n5 Women's College Research Institute, Toronto, ON M5S 1B2, Canada; [ping.sun@wchospital.ca](ping.sun@wchospital.ca) (P.S.); [steven.narod@wchospital.ca](steven.narod@wchospital.ca) (S.A.N.)  \n6 Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada  \n* [Correspondence: jan.lubinski@pum.edu.pl](Correspondence: jan.lubinski@pum.edu.pl); Tel.: +48-91-441-72-50  \nAbstract: In a prospective study, we measured the associations between three serum elements (Se, Zn and Cu) and the prognosis of 1475 patients with four different types of cancer (breast, prostate, lung and larynx) from University Hospitals in Szczecin, Poland. The elements were measured in serum taken after diagnosis and prior to treatment. Patients were followed from the date of diagnosis until death from any cause or until the last follow-up date (mean years of follow-up: 6.0–9.8 years, according to site) . Kaplan–Meier curves were constructed for all cancers combined and for each cancer separately. Age-adjusted hazard ratios (HRs) were estimated using Cox regression. The outcome was all-cause mortality. A Se level in the highest quartile was also associated with a reduced mortality (HR = 0.66; 95%CI 0.49–0.88; p = 0.005) in all-cause mortality for all cancers combined. Zn level in the highest quartile was also associated with reduced mortality (HR = 0.55; 95%CI 0.41–0.75; p = 0.0001) . In contrast, a Cu level in the highest quartile was associated with an increase in mortality (HR = 1.91; 95%CI 1.56–2.08; p = 0.0001) . Three serum elements—selenium, zinc and copper—are associated with the prognosis of different types of cancer.  \nKeywords: copper; zinc; s","cbCaiquob3st06SF","https://ap.wps.com/l/cbCaiquob3st06SF","pdf",2337164,12,"English","# Introduction\n## Selenium","[{\"question\":\"Which serum elements were analyzed and in what patient context?\",\"answer\":\"The study measured selenium, zinc, and copper in serum taken after cancer diagnosis and before treatment, in a prospective cohort of 1475 patients with four cancer types.\"},{\"question\":\"How were outcomes and statistical methods handled?\",\"answer\":\"All-cause mortality served as the outcome. Kaplan–Meier curves were generated, and age-adjusted hazard ratios were estimated using Cox regression.\"},{\"question\":\"What associations were found between each element and survival?\",\"answer\":\"Higher quartile selenium and zinc were linked to reduced all-cause mortality, whereas higher quartile copper was associated with increased mortality.\"}]","Serum Essential Elements and Survival after Cancer Diagnosis | PDF",1790227759]