Baseline 25-Hydroxyvitamin D and Progression-Free Survival in de novo mHSPC: Prognostic Model Development and External Validation.

Authors

Galip Can Uyar, Kadriye Başkurt, Orhun Akdoğan, Enes Yeşilbaş, Mustafa Ersoy, Tuba Uğur Tuzcu, Kadriye Bir Yücel, Mustafa Altınbaş, Ömür Berna Çakmak Öksüzoğlu, Gökşen İnanç İmamoğlu, Osman Sütcüoğlu

Published in

The oncologist. Oct 06, 2026. Epub Oct 06, 2026.

Abstract

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.
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 1,000 bootstrap resamples. Performance was assessed by 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.
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).
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.

PMID:
42836684
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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