Bladder Cancer deaths – 2.9X more likely if low Vitamin D, no death if more than 30 ng – July 2020

Low Plasma 25-Hydoxyvitamin D at Diagnosis Predicts Poor Outcomes in Patients with Bladder Cancer: A Prospective Cohort Study

Nutr Cancer. 2020 Jul 16;1-7. doi: 10.1080/01635581.2020.1737150
Mohamed Kacem Ben Fradj 1 2, Mokhtar Bibi 1 3, Mohamed Bassem Hammami 1 2, Amani Kallel 1 2, Yassine Nouira 1 3, Moncef Feki 1 2

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This study aimed to investigate whether plasma 25-hydroxyvitamin D (25-OHD) at diagnosis predicts poor outcomes in patients with urothelial bladder cancer. A total of 177 patients with non-muscle-invasive bladder cancer (NMIBC) were prospectively followed up over a period extending beyond 6 years. Data on poor outcomes (ie., recurrence, progression, and mortality) were collected. Plasma 25-OHD was measured by immunoassay. Cutoff-Finder web application was used to determine the best 25-OHD cutoff point to predict a specific poor outcome. Cox-hazard models were applied to test how plasma 25-OHD affect patients outcome while adjusting for potential confounding factors.
During the follow-up period,

• tumor recurrence 40.7% of patients
• tumor progression 14.1% of patients
• and 11.3% of patients died.

Baseline 25-OHD was lower in patients who experienced poor outcome (12.2 ± 7.44 vs. 16.7 ± 10.6 ng/mL; p < 0.001).
Multi-adjusted HR (95% CI) for vitamin D deficiency (25-OHD < 12 ng/mL) was

• 2.09 (1.27-3.44) for recurrence
• 2.63 (1.06-6.49) for progression and
• 2.93 (1.04-8.25) for mortality in patients with NMIBC.

Low plasma 25-OHD in NMIBC patients is associated with higher risk of poor outcome. Future work is required to test whether correction of vitamin D deficiency will improve quality of life and extend survival in these patients.