Uyar G. C., Başkurt K., Akdoğan O., Yeşilbaş E., Ersoy M., Uğur Tuzcu T., ...Daha Fazla
ONCOLOGIST, cilt.1, sa.1, ss.1-12, 2026 (SCI-Expanded, Scopus)
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Yayın Türü:
Makale / Tam Makale
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Cilt numarası:
1
Sayı:
1
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Basım Tarihi:
2026
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Doi Numarası:
10.1093/oncolo/oyag396
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Dergi Adı:
ONCOLOGIST
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Derginin Tarandığı İndeksler:
Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Scopus, Sociology Source Ultimate (EBSCO), Science Citation Index Expanded (SCI-EXPANDED), CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
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Sayfa Sayıları:
ss.1-12
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Kütahya Sağlık Bilimleri Üniversitesi Adresli:
Evet
Özet
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 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.
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.