Baseline 25-hydroxyvitamin D and progression-free survival in de novo metastatic hormone-sensitive prostate cancer: prognostic model development and external validation.
- 1Department of Medical Oncology, Etlik City Hospital, Ankara, 06170, Turkey.
- 2Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, 06500, Turkey.
- 3Department of Medical Oncology, Kütahya City Hospital, Kütahya, 43100, Turkey.
Abstract
Background
Prognostic biomarkers for risk stratification remain limited in de novo metastatic hormone-sensitive prostate cancer (mHSPC) treated with androgen receptor pathway inhibitors (ARPIs). We evaluated baseline serum 25-hydroxyvitamin D [25(OH)D] and developed and externally validated a progression-free survival (PFS) model.Methods
This multicenter retrospective study included 273 patients initiating ARPI-based therapy between January 2021 and April 2026. Etlik City Hospital formed the training cohort (n = 192; 85 PFS events), and Gazi University and Kütahya City Hospital formed the external validation cohort (n = 81; 27 PFS events). LASSO-penalized Cox regression retained age, ISUP grade group, CHAARTED disease volume, log-transformed PSA, and hemoglobin. Model B added continuous 25(OH)D. Internal validation used 1000 bootstrap resamples. Performance was assessed by the Harrell C-index, time-dependent AUC, and calibration at 1 and 2 years. PFS was the primary endpoint; overall survival analyses were exploratory. The study was not prospectively registered.Results
Higher baseline 25(OH)D was associated with longer PFS in Model B (HR per 10-ng/mL increase, 0.64; 95% CI, 0.49-0.83; P < .001). Adding 25(OH)D improved model fit (likelihood-ratio χ² = 12.71; P < .001) and increased apparent C-index from 0.712 to 0.740. In external validation, C-indices were 0.71 (95% CI, 0.64-0.78) and 0.76 (95% CI, 0.69-0.83), respectively (Δ = 0.05; 95% CI, 0.01-0.10).Conclusions
Baseline 25(OH)D added modest prognostic information beyond clinical factors, with supportive external validation. These findings do not establish treatment-predictive utility or benefit from vitamin D supplementation. Prospective validation is needed before clinical implementation.
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BibTeX
@article{uyar2026baseline,
title = {{Baseline 25-hydroxyvitamin D and progression-free survival in de novo metastatic hormone-sensitive prostate cancer: prognostic model development and external validation.}},
author = {Galip Can Uyar and Kadriye Başkurt and Orhun Akdoğan and Enes Yeşilbaş and Mustafa Ersoy and Tuba Uğur Tuzcu and Kadriye Bir Yücel and Mustafa Altınbaş and Ömür Berna Çakmak Öksüzoğlu and Gökşen İnanç İmamoğlu and Osman Sütcüoğlu},
journal = {The oncologist},
year = {2026},
month = oct,
doi = {10.1093/oncolo/oyag396},
url = {https://europepmc.org/article/MED/42836684},
note = {CC BY},
}
RIS
TY - JOUR
TI - Baseline 25-hydroxyvitamin D and progression-free survival in de novo metastatic hormone-sensitive prostate cancer: prognostic model development and external validation.
AU - Galip Can Uyar
AU - Kadriye Başkurt
AU - Orhun Akdoğan
AU - Enes Yeşilbaş
AU - Mustafa Ersoy
AU - Tuba Uğur Tuzcu
AU - Kadriye Bir Yücel
AU - Mustafa Altınbaş
AU - Ömür Berna Çakmak Öksüzoğlu
AU - Gökşen İnanç İmamoğlu
AU - Osman Sütcüoğlu
PY - 2026
DA - 2026/10/01
JO - The oncologist
DO - 10.1093/oncolo/oyag396
UR - https://europepmc.org/article/MED/42836684
AB - Background Prognostic biomarkers for risk stratification remain limited in de novo metastatic hormone-sensitive prostate cancer (mHSPC) treated with androgen receptor pathway inhibitors (ARPIs). We evaluated baseline serum 25-hydroxyvitamin D [25(OH)D] and developed and externally validated a progression-free survival (PFS) model.Methods This multicenter retrospective study included 273 patients initiating ARPI-based therapy between January 2021 and April 2026. Etlik City Hospital formed the training cohort (n = 192; 85 PFS events), and Gazi University and Kütahya City Hospital formed the external validation cohort (n = 81; 27 PFS events). LASSO-penalized Cox regression retained age, ISUP grade group, CHAARTED disease volume, log-transformed PSA, and hemoglobin. Model B added continuous 25(OH)D. Internal validation used 1000 bootstrap resamples. Performance was assessed by the Harrell C-index, time-dependent AUC, and calibration at 1 and 2 years. PFS was the primary endpoint; overall survival analyses were exploratory. The study was not prospectively registered.Results Higher baseline 25(OH)D was associated with longer PFS in Model B (HR per 10-ng/mL increase, 0.64; 95% CI, 0.49-0.83; P < .001). Adding 25(OH)D improved model fit (likelihood-ratio χ² = 12.71; P < .001) and increased apparent C-index from 0.712 to 0.740. In external validation, C-indices were 0.71 (95% CI, 0.64-0.78) and 0.76 (95% CI, 0.69-0.83), respectively (Δ = 0.05; 95% CI, 0.01-0.10).Conclusions Baseline 25(OH)D added modest prognostic information beyond clinical factors, with supportive external validation. These findings do not establish treatment-predictive utility or benefit from vitamin D supplementation. Prospective validation is needed before clinical implementation.
SN - 1083-7159
SN - 1549-490X
ER -