title: Serum micronutrient and antioxidant levels at baseline and the natural history of men with localised prostate cancer on active surveillance.
abstract: The aim of this study was to determine whether serum concentrations of micronutrients, antioxidants and vitamins predict rate of disease progression in untreated, localised prostate cancer. Patients with localised prostatic adenocarcinoma on a prospective study of active surveillance underwent monitoring with serial PSA levels and repeat prostate biopsies. Disease progression was defined as either adverse histology on repeat biopsy (primary Gleason grade >or=4 or >50% positive cores of total) or radical treatment for PSA velocity >1 ng ml(-1) year(-1). Time to disease progression was analysed with respect to baseline levels of alpha-tocopherol, gamma-tocopherol, alpha-carotene and beta-carotene, lycopene, retinol and selenium. One hundred four patients were evaluable, with a median follow-up of 2.5 years. Thirty-eight patients experienced disease progression, 13 biochemical and 25 histologic progression. Median time to disease progression was 2.62 years. No significant association was seen between time to disease progression and baseline serum levels of alpha-tocopherol (p = 0.86), gamma-tocopherol (p = 0.84), alpha-carotenoid (p = 0.66), beta-carotene (p = 0.65), lycopene (p = 0.0.15), retinol (p = 0.76) or selenium (p = 0.76). No significant association was seen between serum levels of the micronutrients, antioxidants or vitamins and either adverse histology on repeat biopsy or PSA velocity. Our data do not support the hypothesis that high serum concentrations of micronutrients, antioxidants and vitamins prevent disease progression in men with localised prostate cancer.
authors.affiliation: Department of Clinical Oncology, Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK. drvramachandran@gmail.com
authors.forename: Ramachandran
authors.initials: R
authors.lastname: Venkitaraman
authors.forename: Karen
authors.initials: K
authors.lastname: Thomas
authors.forename: Phillip
authors.initials: P
authors.lastname: Grace
authors.forename: David P
authors.initials: DP
authors.lastname: Dearnaley
authors.forename: Alan
authors.initials: A
authors.lastname: Horwich
authors.forename: Robert A
authors.initials: RA
authors.lastname: Huddart
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Parker
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D002338:Carotenoids / Q000097:blood; D006801:Humans; D000077276:Lycopene; D008297:Male; D018977:Micronutrients / Q000097:blood*; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood*; D014810:Vitamin E / Q000097:blood; D019207:beta Carotene / Q000097:blood
chemical_list: D000975:Antioxidants; D018977:Micronutrients; D019207:beta Carotene; D014810:Vitamin E; D002338:Carotenoids; D017430:Prostate-Specific Antigen; D000077276:Lycopene