Enteral Vitamin B&lt;sub&gt;12&lt;/sub&gt; Supplementation Is Effective for Improving Anemia in Patients Who Underwent Total Gastrectomy

Namikawa, Tsutomu; Yokota, Keiichiro; Iwabu, Jun; Munekage, Masaya; Uemura, Sunao; Maeda, Hiromichi; Kitagawa, Hiroyuki; Kobayashi, Mariko; Hanazaki, Kazuhiro

doi:10.1159/000513888

Cited by 10 publications

(15 citation statements)

References 24 publications

(32 reference statements)

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“…Intramuscular injection of vitamin B12 is generally suggested as the treatment of choice in TG patients deprived of intrinsic factors. At the same time, daily oral vitamin B12 supplementation at a high dosage (1,500 µg once daily) can be an alternative option with similar efficacy [ 459 460 461 ].…”

Section: Follow Up and Nutritional Considerationsmentioning

confidence: 99%

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

et al. 2023

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Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

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Section: Follow Up and Nutritional Considerationsmentioning

confidence: 99%

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

et al. 2023

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“…Similar results were observed in previous studies. In the study of Namikawa et al, vitamin B12 levels before supplementation and at 3, 6, and 12 months after supplementation were significantly higher in patients who received supplementation via the enteral route than via the parenteral route (13). Moreover, the study of Kim et al showed that oral vitamin B12 replacement increased serum vitamin B12 levels over time (14).…”

Section: Discussionmentioning

confidence: 96%

“…Limited studies have presented the changes in vitamin B12 levels after total gastrectomy. Namikawa et al investigated the efficacy of enteral supplementation of vitamin B12 for vitamin B12 deficiency in patients who had undergone total gastrectomy for gastric cancer (13). They reported that vitamin B12 deficiency was observed in >70% of patients who underwent total gastrectomy for gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Similar results have been reported in previous studies. Namikawa et al reported that the median serum vitamin B12 level was 136 pg/ml at 3 months after parenteral supplementation, 149 pg/ml at 6 months after parenteral supplementation, and 172 pg/ml at 12 months after parenteral supplementation (13). In addition, in the study by Kim et al, which compared the efficacy between oral and intramuscular vitamin B12 replacement, the mean serum vitamin B12 levels of the intramuscular administration group peaked after the weekly booster injection period but decreased at 2 months (14).…”

Section: Discussionmentioning

confidence: 99%

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Clinical Course of Vitamin B12 Deficiency and Associated Risk Factors in Patients After Total Gastrectomy for Gastric Cancer

et al. 2023

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Background/Aim: Patients are at-risk for vitamin B12 deficiency after total gastrectomy due to a lack of intrinsic factors. The aim of the study was to clarify the clinical course and risk factors for vitamin B12 deficiency after total gastrectomy for gastric cancer patients. Patients and Methods: Patients who underwent curative resection for gastric cancer were selected from the medical records of the Yokohama City University from 2000 to 2020. A logistic regression analysis was performed to identify risk factors for vitamin B12 deficiency. Results: We evaluated 47 patients. The median serum vitamin B12 levels before surgery were 359 pg/ml, while those at 3, 6, 9, and 12 months after surgery these were 255 pg/ml, 197.5 pg/ml, 195 pg/ml, and 206 pg/ml, respectively. Univariate analyses to identify factors associated with vitamin B12 deficiency at 6 months after surgery showed that the occurrence of postoperative complications was a significant risk factor (OR=6.347, p=0.009), while adjuvant chemotherapy was a marginally significantly risk factor (OR=3.562, p=0.076). Conclusion: Almost half of the patients were diagnosed with vitamin B12 deficiency at 6 months after total gastrectomy for gastric cancer. In addition, the occurrence of postoperative complications and adjuvant chemotherapy were risk factors for vitamin B12 deficiency at 6 months after surgery.

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“…Specific to vitamin B 12 supplementation, there has been study of the efficacy of enteral vs intramuscular supplementation in patients following gastrectomy for gastric cancer. 22,23 Two studies found enteral B 12 supplementation to be more efficacious overall in leading to higher B 12 levels and more rapid increase in levels. One of these studies demonstrated resolved symptoms of deficiency over a 4-year period with both enteral and intramuscular supplementation, 23 whereas the other study showed an increase in median red blood cell count in those receiving enteral supplementation, suggesting improvement in anemia.…”

Section: B Vitaminsmentioning

confidence: 99%

Micronutrient deficiencies in patients with gastrointestinal cancer: To treat or not to treat

Turkiewicz

García²,

Li³

et al. 2023

Nut in Clin Prac

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Nutrition supplements are widely used among patients with cancer. The general public perceives supplements as more natural anticancer and antitoxicity agents, and often supplements are used without the knowledge of the treating physician. In the clinical setting, there are concerns that supplements may decrease effectiveness of chemotherapy and/or radiotherapy and, as a result, supplementation is avoided. There is a body of literature evaluating micronutrient deficiencies, supplementation, and cancer risk; however, little is known about the risks of treatment of micronutrient deficiencies in specific cancers. Of the types of cancers, patients with gastrointestinal cancers are at high risk of developing malnutrition and, subsequently, possible micronutrient deficiencies. This review aims to evaluate the effects of supplementation of specific micronutrients in patients with cancer of the digestive tract.

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Enteral Vitamin B<sub>12</sub> Supplementation Is Effective for Improving Anemia in Patients Who Underwent Total Gastrectomy

Cited by 10 publications

References 24 publications

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

Clinical Course of Vitamin B12 Deficiency and Associated Risk Factors in Patients After Total Gastrectomy for Gastric Cancer

Micronutrient deficiencies in patients with gastrointestinal cancer: To treat or not to treat

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