Association Between Pretreatment Blood 25-Hydroxyvitamin D Level and Survival Outcomes in Patients With Clinically Localized Prostate Cancer: An Updated Meta-Analysis

Abstract

Studies on the prognostic value of the blood 25-hydroxyvitamin D level have yielded controversial results in prostate cancer (PCa) patients. This updated meta-analysis aimed to evaluate the association between pretreatment 25-hydroxyvitamin D level with survival outcomes among patients with clinically localized PCa. PubMed, Web of Science, and Embase databases were searched to identify studies evaluating the association of pretreatment 25-hydroxyvitamin D level with PCSM and all-cause mortality among clinically localized PCa patients. Ten cohort studies with 10,394 patients were identified. The meta-analysis revealed that PCa patients with the lowest 25-hydroxyvitamin D levels had an increased risk of PCSM (adjusted hazard ratio [HR] 1.52; 95% confidence interval [CI] 1.26-1.83; p < 0.001) and all-cause mortality (adjusted HR 1.31; 95% CI 1.00-1.90; p = 0.047) compared to those with higher reference 25-hydroxyvitamin D level. Subgroup analyses based on different sample sizes, follow-up duration, and adjusted times of blood draw also exhibited a significant association of vitamin D deficiency with the risk of PCSM. Lower pretreatment level of 25-hydroxyvitamin D may be an independent predictor of reduced survival in patients with clinically localized PCa. Measuring the pretreatment blood 25-hydroxyvitamin D level can provide valuable information for risk stratification of survival outcomes in these patients.

Authors’ Contribution

Study conception/design and interpretation of data: Y Fan and C Zou. Literature search, study selection, data extraction, quality assessment, statistical analysis: FL Cui, Y Qiu, W Xu. Writing (draft): Y Qiu. Writing (editing): FL Cui. All the authors reviewed and approved the final version of the manuscript.

Disclosure Statement

All authors declare that there is no conflict of interest.

Data Availability Statement

The available data and materials section refers to the raw data used in this study are included in manuscript.

Additional information

Funding

This work is supported by 1) Provincial Natural Science Foundation Project of Jiangsu of China (BK20191221), 2) Social Development Plan of Jiangsu Province-Standardization of Key Disease Diagnosis and Treatment Project (BE2016715), and 3) Key projects of Jiangsu Provincial Health Commission (K2023016).