Serum Vitamin D Levels Predict Adverse Pathology at Prostatectomy

Both insufficiency and deficiency of serum vitamin D correlated with an increased risk of unfavorable pathology in men undergoing radical prostatectomy for prostate cancer, a study published in the Journal of Clinical Oncology has shown. This study suggested serum vitamin D levels could serve as a biomarker of cancer aggressiveness.1

Researchers conducted this study between 2009 and 2014 as part of a larger, cross sectional examination of 1760 healthy controls and men undergoing prostate cancer screening. From the cohort, 190 men underwent radical prostatectomy. Extraprostatic extension or the presence of primary Gleason 4 or Gleason 5 disease characterized adverse pathology.

Multivariate and descriptive analyses evaluated the potential correlations between serum vitamin D levels and adverse pathology at the time of radical prostatectomy.

At radical prostatectomy, 87 men (45.8%) exhibited adverse pathology. Men with adverse pathology exhibited lower serum vitamin D levels (22.7 ng/mL) than men without adverse pathology (27.0 ng/mL, P=.007).

"Vitamin D deficiency may predict aggressive prostate cancer as a biomarker," said Adam Murphy, MD, an assistant professor of urology at Northwestern University Feinberg School of Medicine, Evanston, Illinois, and lead investigator in the study.

Men with dark skin, low vitamin D intake, or low sun exposure should be tested for vitamin D deficiency when an elevated PSA or prostate cancer is diagnosed, and any deficiency should be corrected with supplements, Murphy said.

Serum vitamin D levels less than 30 ng/mL correlated with increased odds of adverse pathology (odds ratio, 2.64; 95% CI, 1.25 to 5.59; P=.01) when age, serum prostate specific antigen, and abnormal digital rectal examination were controlled. The cohort's median age was 64.0 years.

Serum vitamin D levels might help patients determine whether they should undergo prostatectomy. Low levels of serum vitamin D could arise from dark skin, lack of sun, or diet.

"All men should be replenishing their vitamin D to normal levels. It's smart preventive health care," suggested Murphy.

REFERENCE

1. Nyame YA, Murphy AB, Bowen DK, et al. Associations between serum vitamin D and adverse pathology in men undergoing radical prostatectomy [published online ahead of print February 22, 2016]. J Clin Oncol. doi:10.1200/JCO.2015.65.1463.

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