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Vitamin D and adverse pathologic features in patients undergoing radical prostatectomy in the contemporary magnetic resonance imaging-guided management era.

Created on 05 Aug 2026

Authors

Sarita Chitjaroen, Kantima Jongjitaree, Varat Woranisarakul, Siros Jitpraphai, Tawatchai Taweemonkongsap, Sunai Leewansangtong, Sittiporn Srinualnad, Thitipat Hansomwong

Published in

BJUI compass. Volume 7. Issue 8. Pages e70261. Epub Aug 04, 2026.

Abstract

This study aimed to evaluate the association between serum 25-hydroxyvitamin D (25-OH D) levels and adverse pathologic features in patients undergoing radical prostatectomy (RP) in the contemporary magnetic resonance imaging (MRI)-guided management era.
This retrospective study included patients who underwent RP between January 2022 and December 2024 at a single academic centre. Preoperative MRI was routinely incorporated into staging and treatment planning. Serum 25-OH D levels measured within 3 months prior to surgery were analysed. Vitamin D insufficiency was defined as 20-29.99 ng/mL and deficiency as <20 ng/mL. Adverse pathologic features included International Society of Urological Pathology (ISUP) Grade Group 4 or 5, extraprostatic extension (EPE), seminal vesicle invasion (SVI) and pelvic lymph node metastasis. Associations were evaluated using multivariable logistic regression analysis.
A total of 217 patients were included. Preoperative MRI was performed in 96.0% of patients and MRI-targeted biopsy in 78.3%. Adverse pathologic features were identified in 66.4% of patients. Vitamin D insufficiency and deficiency were present in 67.3% and 17.5%, respectively. Mean serum 25-OH D levels did not differ significantly between patients with and without adverse pathology (28.19 ± 8.41 ng/mL vs. 27.46 ± 9.26 ng/mL, p = 0.55). In multivariable analysis, body mass index and adverse MRI findings were independently associated with adverse pathology, whereas serum 25-OH D levels were not. An exploratory subgroup analysis demonstrated an association between serum 25-OH D levels and EPE in very-high-risk patients.
Serum 25-OH D levels were not independently associated with adverse pathologic features following RP in this contemporary MRI-guided management cohort. While established clinical and radiologic factors remain the primary predictors of adverse pathology, further studies are needed to clarify the role of vitamin D in long-term oncologic and functional outcomes.

PMID:
42553583
Bibliographic data and abstract were imported from PubMed on 05 Aug 2026.

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