Randomized clinical trial of preoperative weight loss in patients with excess weight and colorectal cancer

Excess weight increases morbidity risk after colorectal cancer surgery. The randomized CARE trial at 8 hospitals across England assessed the feasibility of preoperative weight loss intervention among patients with excess weight and colorectal cancer. The trial included 71 individuals with a body mass index of 28 kg/m² who were awaiting curative elective colorectal cancer resection. Patients were randomized to a low-energy diet (800 kcal/d, 76 g/d of protein; n=36) or usual care (n=35). The patients in the intervention group lost on average 4.3 kg more weight than the usual care group within 33 days until surgery, with no evidence of between-group differences in fat-free mass and physical function. Modeling indicated that the intervention was cost-effective. The authors conclude that these data suggest that intentional weight loss before colorectal cancer surgery is safe, feasible, and likely cost-effective.