Martini-Klinik, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
Eur Urol Focus. 2021 Sep;7(5):973-979. doi: 10.1016/j.euf.2020.12.005. Epub 2021 Jan 3.
Dietary agents, in particular vitamin D (Vit D) and selenium, are widely used by prostate cancer (PCa) patients to improve cancer outcomes.
To investigate whether plasma Vit D and selenium levels prior to radical prostatectomy (RP) are associated with worse pathologic tumor characteristics and increased risk of disease recurrence.
DESIGN, SETTING, AND PARTICIPANTS: A total of 3849 men with PCa scheduled for RP in the Martini-Klinik at the University Hospital Hamburg-Eppendorf, Hamburg, Germany, between January 2014 and December 2018 were included in this study.
Age, and clinical and laboratory values were collected prior to RP. Biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) ≥0.2 μg/l and rising after RP. Kaplan-Meier plots depicted BCR-free survival. Cox regression models (adjusted for age, preoperative PSA, pT stage, pN stage, pGG, surgical margin status, and year of surgery) tested the relationship between oncologic outcomes and Vit D and selenium levels.
Median plasma Vit D and selenium levels were 19.3 and 71 μg/l, respectively. Circulating Vit D and selenium levels correlated inversely with PSA values. Histologic grade, pT stage, and pN stage were not associated with Vit D and selenium levels at the time of RP. In the overall cohort, BCR-free survival at 3 yr of follow-up was 82.9%. When stratified according to median Vit D levels, BCR-free survival at 3 yr of follow-up was 82.7% and 83.0% (p ≤ 0.59). Upon stratification according to median selenium levels, BCR-free survival was 82.2% and 83.7% (p = 0.19). In a multivariable Cox regression model predicting BCR, lower Vit D and selenium levels were not independent predictors of BCR.
Plasma Vit D and selenium levels prior to RP were not associated with BCR-free survival.
The results of the MARTINI-Lifestyle cohort could not show a correlation between the occurrence of biochemical recurrence of prostate cancer after radical prostatectomy and the serum levels of vitamin D and selenium. A recommendation should therefore be made to compensate for a potential deficiency and not with the expectation of a reduction in the risk of progression.
膳食补充剂，特别是维生素 D（Vit D）和硒，被广泛应用于前列腺癌（PCa）患者以改善癌症结局。
研究根治性前列腺切除术（RP）前的血浆 Vit D 和硒水平是否与更差的病理肿瘤特征和疾病复发风险增加相关。
设计、地点和参与者：本研究共纳入了 2014 年 1 月至 2018 年 12 月期间在德国汉堡-埃彭多夫大学医院马蒂尼诊所接受 RP 的 3849 名 PCa 患者。
收集 RP 前的年龄、临床和实验室值。生化复发（BCR）定义为 PSA≥0.2μg/l 并在 RP 后升高。Kaplan-Meier 图描绘了 BCR 无复发生存率。Cox 回归模型（调整年龄、术前 PSA、pT 分期、pN 分期、pGG、手术切缘状态和手术年份）检验了肿瘤学结局与 Vit D 和硒水平之间的关系。
中位血浆 Vit D 和硒水平分别为 19.3μg/l 和 71μg/l。循环 Vit D 和硒水平与 PSA 值呈负相关。组织学分级、pT 分期和 pN 分期与 RP 时的 Vit D 和硒水平无关。在整个队列中，3 年随访时的 BCR 无复发生存率为 82.9%。根据中位 Vit D 水平分层，3 年随访时的 BCR 无复发生存率分别为 82.7%和 83.0%（p≤0.59）。根据中位硒水平分层，BCR 无复发生存率分别为 82.2%和 83.7%（p=0.19）。在多变量 Cox 回归模型预测 BCR 中，较低的 Vit D 和硒水平不是 BCR 的独立预测因素。
RP 前的血浆 Vit D 和硒水平与 BCR 无复发生存率无关。
MARTINI-Lifestyle 队列的研究结果未能显示根治性前列腺切除术后前列腺癌生化复发的发生与血清维生素 D 和硒水平之间存在相关性。因此，建议补充潜在的缺乏，但不应期望降低进展风险。
