Abstract OBJECTIVE: To determine the association of lipid-soluble vitamin status with survival in colorectal cancer patients. METHODS: Using stored patient plasma samples from a multiethnic population-based case-control study of colorectal cancer, we determined associations of post-treatment blood levels of retinol, 25 OH-vitamin D, and Vitamin E with survival. Patients (n = 455) were followed (mean of 8 years) after phlebotomy, during which time 20% died of colorectal cancer and 24% from other causes. Hazard ratios (HR) were estimated by Cox proportional hazards regression with adjustment for stage and age at diagnosis, ethnicity, sex, and smoking status. RESULTS: A strong inverse association with all-cause mortality was observed for plasma retinol (Ptrend <0.0001), with similar significant trends observed for both colorectal cancer-specific deaths and other causes of death (P for heterogeneity = 0.43). The inverse association between retinol and all cause mortality was consistently observed for both sexes, subjects of Caucasian and Japanese ancestry, and for both rectal cancer and colon cancer. Overall no significant associations were observed for plasma 25-OH vitamin D or vitamin E with survival. CONCLUSIONS: Results are consistent with a direct relationship between low vitamin A status and poor survival among colorectal cancer patients. The absence of a significant association for 25-OH vitamin D levels with survival may be related to the generally higher circulating levels of 25-OH vitamin D in residents of Hawaii where the study was conducted, and results may differ in northern climates and in darker pigmented patients. If verified through larger prospective studies, future complementary intervention trials involving the assessment of vitamin A status and supplementation of individuals with inadequate levels may be warranted. Citation Format: Robert V. Cooney, Weiwen Chai, Adrian A. Franke, Christian Caberto, Lynne R. Wilkens, Laurence N. Kolonel, Laurie Custer, Cynthia Morrison, Loic Le Marchand. Plasma retinol, but not 25-OH vitamin D or vitamin E, is associated with increased survival in colorectal cancer patients. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4821. doi:10.1158/1538-7445.AM2013-4821