Current knowledge on the role of retinol in the prognosis of patients with colorectal cancer\n(CRC) is very limited. We investigated the association of serum retinol levels with survival outcomes\nin a large cohort of 2908 CRC patients from Germany. Retinol concentrations were determined in\nserum collected shortly after diagnosis by mass spectrometry. Associations between serum retinol\nlevels and survival outcomes were assessed using multivariable Cox regression and dose-response\nanalyses. The joint association of serum retinol and serum 25-hydroxyvitamin D3 (25(OH)D3) with\nsurvival outcomes was also examined. During a median follow-up of 4.8 years, 787 deaths occurred,\n573 of which were due to CRC. Dose-response curves showed an inverse relationship between serum\nretinol levels and survival endpoints in the range of <2.4 Ã?¼mol/L, but no associations at higher levels.\nLow (<1.2 Ã?¼mol/L) versus high (ââ?°Â¥2.4 Ã?¼mol/L) serum retinol levels were associated with poorer\noverall survival (Hazard ratio (HR) = 1.46, 95% confidence interval (CI) = 1.19ââ?¬â??1.78, P-trend = 0.0003)\nand CRC-specific survival (HR = 1.69, 95% CI = 1.33ââ?¬â??2.15, P-trend < 0.0001). Joint presence of low\nserum retinol (<1.2 Ã?¼mol/L) and low 25(OH)D3 (<30 nmol/L) was associated with a particularly\nstrong decrease in overall and CRC-specific survival. Low serum retinol levels were identified\nas a predictor of poor survival in CRC patients, in particular when co-occurring with low serum\nconcentrations of 25(OH)D3. The clinical implications of these findings require further investigation.
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