Serum Vitamin D is not Helpful in Predicting Prostate Cancer Aggressiveness Compared with the Prostate Health Index.

PURPOSE - We evaluated the usefulness of serum 25-hydroxyvitamin D (VitD) as a marker of aggressive prostate cancer (PCa) and for active surveillance in comparison with the Prostate Health Index.

MATERIALS AND METHODS - Out of 480 prospectively biopsied men 222 had PCa and 258 had no evidence of malignancy (NEM).

All men had PSA values

RESULTS - VitD concentrations were not associated to the Gleason grade according to the consensus conference of the International Society of Urological Pathology (2014 ISUP Gleason grading system) while the prostate health index (PHI) values were higher with increasing Gleason grade. Median VitD concentration did not differ between PCa and NEM (50.6 vs. 48.2 nmol/l, p=0.192) or within ISUP Gleason subgroups despite the seasonal variations of VitD, whereas PHI values were significantly different between NEM and all Gleason subgroups (p<0.0001). Receiver operating characteristics for all men provided an advantage of PHI over VitD (AUC 0.78 vs. 0.535, p<0.0001). PHI could also significantly better separate NEM and nonaggressive (ISUP Gleason grade 1) from aggressive PCa (ISUP Gleason grades 2-5).

CONCLUSIONS - It remains highly improbable that VitD could be used as decision or selection marker of aggressive PCa or for active surveillance in comparison to accepted markers as recently suggested.

The Journal of urology. 2016 Mar 11 [Epub ahead of print]

Carsten Stephan, Michael Lein, Julia Matalon, Ergin Kilic, Zhongwei Zhao, Jonas Busch, Klaus Jung

Department of Urology, Charité - Universitätsmedizin Berlin, Germany; Berlin Institute for Urologic Research, Berlin, Germany. Department of Urology, Sana Hospital, Offenbach, Germany., Department of Urology, Charité - Universitätsmedizin Berlin, Germany., Department of Pathology, Charité - Universitätsmedizin Berlin, Germany., Department of Urology, Charité - Universitätsmedizin Berlin, Germany; Department of Urology, Xiangya Hospital of Central South University, Hunan, China., Department of Urology, Charité - Universitätsmedizin Berlin, Germany., Department of Urology, Charité - Universitätsmedizin Berlin, Germany; Berlin Institute for Urologic Research, Berlin, Germany.