Lower Vitamin D Levels Associated With Adverse Pathology at Prostatectomy in Men With Localized Prostate Cancer


Key Points

  • Patients with adverse pathology at radical prostatectomy had lower vitamin D levels.
  • A vitamin D level < 30 ng/mL was associated with 2.6-fold increased risk of adverse pathology.

In a study reported in the Journal of Clinical Oncology, Nyame et al found that lower serum 25-hydroxyvitamin D (25-OH D) levels were associated with an increased likelihood of adverse pathology at radical prostatectomy in men with localized prostate cancer.

Study Details

The cross-sectional study was performed between 2009 to 2014, nested within an epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer screening at sites in Chicago. Adverse pathology at prostatectomy was defined as primary Gleason 4 or any Gleason 5 disease or extraprostatic extension.

Vitamin D and Risk

In total, 190 men underwent radical prostatectomy, with 87 men (45.8%) having adverse pathology at radical prostatectomy. On univariate analysis, men with adverse pathology had lower median serum 25-OH D levels (22.7 vs 27.0 ng/mL, P = .007) compared with other patients in the prostatectomy cohort. Other factors associated with an increased risk of adverse pathology were older age (65.0 vs 62.0 years, P = .005), body mass index (median, 28.9 vs 27.7 kg/m2, P = .04), and serum prostate-specific antigen (PSA; median, 6.8 vs 4.4 ng/mL, P < .001). Black patients accounted for a greater proportion of those with adverse vs nonadverse pathology (32% vs 17%). On multivariate analysis adjusting for age, serum PSA, and abnormal digital rectal examination, serum 25-OH D level < 30 ng/mL was associated with a significantly increased risk of adverse pathology (odds ratio = 2.64, P = .01).

The investigators concluded: “Insufficiency/deficiency of serum 25-OH D is associated with increased odds of adverse pathology in men with localized disease undergoing radical prostatectomy. Serum 25-OH D may serve as a useful biomarker in prostate cancer aggressiveness, which deserves continued study.”

The U.S. Department of Defense and the National Institutes of Health supported this study.

Adam B. Murphy, MD, of Northwestern University, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.