A feasibility study of perioperative vitamin D supplementation in patients undergoing colorectal cancer resection

BACKGROUNDPost-operative vitamin D supplementation improves CRC survival outcomes in randomised trials. The aim of this study was to test the feasibility, safety and efficacy of vitamin D in the pre- and perioperative period in patients undergoing CRC surgery. METHODSPatients were given 3200IU oral cholecalciferol per day perioperatively. Serial serum 25OHD was measured by liquid chromatography tandem mass spectrometry and compared to untreated CRC controls. 25OHD/CRP levels were compared using adjusted generalized linear mixed-effects models. RESULTS122 patients underwent serial perioperative sampling, including 41 patients given high-dose perioperative supplementation. 25OHD was higher in patients given high-dose supplementation compared to controls at all peri-operative timepoints (P<0.001) and supplementation attenuated the post-operative drop in 25OHD (46% vs 24% drop). Rate of vitamin D insufficiency was significantly less in those on supplementation (14% vs. 56%, P=0.003), with multivariate modelling indicating a [~]60nmol/l higher 25OHD compared to control patients (P=1.22E-15). Supplementation was associated with lower peri-operative CRP (P=0.035). DISCUSSIONSHigh dose pre-operative vitamin D supplementation is associated with higher perioperative 25OHD levels, lower rates of vitamin D insufficiency and reduced early postoperative CRP. These findings provide compelling rationale for early initiation of vitamin D supplementation after a diagnosis of CRC.