Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy.

PURPOSE - Lower serum vitamin D levels have been associated with an increased risk of aggressive prostate cancer. Among men with localized prostate cancer, especially with low- or intermediate-risk disease, vitamin D may serve as an important biomarker of disease aggression.

The aim of this study was to assess the relationship between adverse pathology at the time of radical prostatectomy and serum 25-hydroxyvitamin D (25-OH D) levels.

METHODS - This cross-sectional study was carried out from 2009 to 2014, nested within a large epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer screening. In total, 190 men underwent radical prostatectomy in the cohort. Adverse pathology was defined as the presence of primary Gleason 4 or any Gleason 5 disease, or extraprostatic extension. Descriptive and multivariate analyses were performed to assess the relationship between 25-OH D and adverse pathology at the time of prostatectomy.

RESULTS - Eighty-seven men (45.8%) in this cohort demonstrated adverse pathology at radical prostatectomy. The median age in the cohort was 64.0 years (interquartile range, 59.0 to 67.0). On univariate analysis, men with adverse pathology at radical prostatectomy demonstrated lower median serum 25-OH D (22.7 v 27.0 ng/mL, P = .007) compared with their counterparts. On multivariate analysis, controlling for age, serum prostate specific antigen, and abnormal digital rectal examination, serum 25-OH D less than 30 ng/mL was associated with increased odds of adverse pathology (odds ratio, 2.64; 95% CI, 1.25 to 5.59; P = .01).

CONCLUSIONS - 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.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2016 Feb 22 [Epub ahead of print]

Yaw A Nyame, Adam B Murphy, Diana K Bowen, Gregory Jordan, Ken Batai, Michael Dixon, Courtney M P Hollowell, Stephanie Kielb, Joshua J Meeks, Peter H Gann, Virgilia Macias, Andre Kajdacsy-Balla, William J Catalona, Rick Kittles

Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ. ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ., Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.