Higher Post-operative Serum Vitamin D Level Is Associated With Better Survival Outcome In Colorectal Cancer Patients

Antonio Markotic, Sanja Langer, Tomislav Kelava, Katarina Vuvic, Petra Turcic, Tomislav Tokic, Ljilia Stefancic, Eva Radetic, Susan Farrington, Maria Timofeeva, Igor Rudan, Harry Campbell, Malcolm Dunlop, Iva Kirac, Lina Zgaga

Research output: Contribution to journalArticlepeer-review


25-hydroxyvitamin D (25-OHD) may have a prognostic value in colorectal cancer (CRC) patients. However, as 25-OHD concentration is strongly impacted by surgery, it is uncertain what is the most reliable time-point for 25-OHD assessment, pre- or post-operative. Therefore, we examined 515 CRC patients (AJCC I-III) who underwent surgery. Blood samples were collected either pre-operatively (n=286; median=1 day before surgery) or post-operatively (n=229; median=8 days). Serum 25-OHD concentration was determined by liquid chromatography-tandem mass spectrometry. Association between 25-OHD and survival was tested in the whole cohort, followed by stratified analyses in pre-and post-operatively sampled. Median 25-OHD in the cohort was 36.7 nmol/L and median follow-up time was 5.9 years. There were no differences between pre-and post-operative cohort in age, sex, 25-OHD, AJCC stage or localization of tumour. After adjustment, higher 25-OHD (>50 nmol/L) was associated with better overall survival only in post-operative (HR=0.53; 95%CI: 0.33-0.84; P=0.006), but not in pre-operative cohort (HR=1.13; 95%CI: 0.77-1.65; P=0.53). In conclusion, higher post-operative 25-OHD levels were associated with better survival outcome in CRC patients, while no such association was found for pre-operative levels. Time-point of blood collection should be addressed carefully in future research as it might affect the prognostic value of 25-OHD in CRC
Original languageEnglish
JournalNutrition and cancer
Early online date4 Apr 2019
Publication statusE-pub ahead of print - 4 Apr 2019


  • vitamin D
  • survival
  • colorectal cancer
  • surgery

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