Nutritional deficiency post esophageal and gastric cancer surgery: A quality improvement study

Veeralakshmanan, Pushpa; Tham, Ji Chung; Amy, Wright; Bolter, Marilyn; Wadhawan, Himanshu; Humphreys, Lee; Sanders, G; Wheatley, Tim; Berrisford, Richard

doi:10.1016/j.amsu.2020.05.032

Cited by 18 publications

(34 citation statements)

References 15 publications

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“…Zhang et al [ 11 ] analyzed the vitamin nutritional status of approximately 1000 hospitalized tumor patients and found that vitamin B1 concentrations were low in patients with digestive system tumors such as EC and gastric cancer. A study on postoperative nutritional deficiencies in patients with EC or gastric cancer revealed that the incidence of ferritin, folic acid, vitamin B 12 and vitamin D deficiencies was 42.86%, 9.52%, 6.35% and 36.67%, respectively, and the vitamin levels were significantly improved after nutritional interventions[ 12 ]. In another study[ 13 ], most patients with advanced tumors had vitamin (particularly vitamins D, B 6 and C) deficiency symptoms during palliative care, and further analysis revealed a correlation between the degree of vitamin deficiency and clinical discomfort in these patients.…”

Section: Introductionmentioning

confidence: 99%

Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy

Lang¹,

Meng²,

Cai³

et al. 2021

WJG

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BACKGROUND Many studies have investigated the relationships between vitamins and esophageal cancer (EC). Most of these studies focused on the roles of vitamins in the prevention and treatment of EC, and few studies have examined the changes in vitamin nutritional status and their influencing factors before and after chemotherapy for EC. Chemotherapy may have a considerable effect on EC patients’ vitamin levels and hematological indicators. AIM To research the nutritional status of multiple vitamins in EC patients during chemotherapy and to assess its clinical significance. METHODS EC patients admitted to our center from July 2017 to September 2020 were enrolled in this study. Serum concentrations of nine vitamins (A, D, E, B 9 , B 12 , B 1 , C, B 2 and B 6 ), hemoglobin, total protein, albumin, blood calcium, blood phosphorus concentrations and body mass index (BMI) were measured in all EC patients. The changes in nine vitamins, hematological indicators and BMI were compared before and after two cycles of chemotherapy. The possible influential factors were analyzed. RESULTS In total, 203 EC patients receiving chemotherapy were enrolled in this study. Varying degrees of vitamin A, D, C and B 2 deficiency and weight loss were found in these patients, and the proportions of vitamin B 2 and vitamin C deficiencies increased significantly after chemotherapy (both P < 0.05). Serum concentrations of vitamins A, C, B 2 and B 6 and BMI before and after chemotherapy were statistically significant (all P < 0.05). Multivariate analysis showed that vitamin A levels significantly differed between male and female EC patients, whereas vitamin D concentration significantly differed in EC patients in different stages (all P < 0.05). Correlations were observed between the changes in serum concentrations of vitamin A and C before and after two cycles chemotherapy and the change in BMI ( P < 0.05). Hemoglobin, total protein, serum albumin and blood calcium concentrations significantly decreased in EC patients after chemotherapy (all P < 0.05), while the blood phosphorus level significantly increased after chemotherapy ( P < 0.05). Using the difference in vitamin concentrations as the independent variables and the difference in BMI as the dependent variable, logistic regression analysis revealed statistically significant differences for vitamin A, vitamin D and vitamin C (F = 5.082, P = 0.002). CONCLUSION Vitamin A, D, C and B 2 were mainly deficient in p...

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Section: Introductionmentioning

confidence: 99%

Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy

Lang¹,

Meng²,

Cai³

et al. 2021

WJG

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show abstract

“…The investigated vitamin D metabolites were 25(OH)D (11 studies) [14,[17][18][19]21,[23][24][25][26]28,31], 1,25(OH) 2 D (6 studies) [14,17,24,25,27,31], and 24,25(OH) 2 D (2 studies) [24,31]. Six studies did not report the investigated metabolite [15,16,20,22,29,30], declaring that they analyzed "serum vitamin D". The other concomitant and most frequently analyzed parameters were bone mineral density (nine studies) [14,16,17,[19][20][21]23,26,30], serum estradiol level (three studies) [14,17,25] and other bone metabolism biomarkers, as part of the studies focused on bone density and risk of osteoporosis after gastric cancer surgery with vitamin D and its metabolites evaluated only as indicators.…”

Section: Rino Y Et Al [27] 16 Patientsmentioning

confidence: 99%

“…In seven out of 18 studies, vitamin D had been supplemented in patients with gastric cancer who underwent gastrectomy [15,16,19,21,22,26,27]. However, only two studies reported the doses administered, ranging from 1000 IU of cholecalciferol per day with calcium or 70 mg/week of alendronate [16] to 16,000 IU of vitamin D 3 administered every 10 days [19].…”

Section: Rino Y Et Al [27] 16 Patientsmentioning

confidence: 99%

“…However, only two studies reported the doses administered, ranging from 1000 IU of cholecalciferol per day with calcium or 70 mg/week of alendronate [16] to 16,000 IU of vitamin D 3 administered every 10 days [19]. Virik [21], Ribeiro [22], Cuerda [26], Veeralakshmanan [15], and Rino [27] only reported that patients were supplemented with vitamin D and/or calcium, multivitamin and mineral supplement, or 1α(OH)D 3 , with no report of daily doses, the regimen of administration, type of supplementation, or information whether it was advised by the physician or performed by the patient himself. The reported supplementing time ranged from 12 to 18 months [15,16,19,21,22,26,27].…”

Section: Rino Y Et Al [27] 16 Patientsmentioning

confidence: 99%

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Vitamin D—The Nutritional Status of Post-Gastrectomy Gastric Cancer Patients—Systematic Review

et al. 2022

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Gastric cancer is a malignant neoplasm of the gastrointestinal tract, with one of the standard treatment methods remaining gastrectomy. The authors conducted a systemic review of the Medline and Embase databases concerning the serum vitamin D level in post-gastrectomy gastric cancer patients, regarding all articles published until 22 May 2022 according to the PRISMA guidelines. 18 studies with a total number of 908 gastric cancer survivors were included in the analysis. The initial rate of vitamin D deficiency in gastric cancer patients undergoing gastrectomy appears to be similar to the global population deficiency. In post-gastrectomy survivors, the level of 25(OH)D may remain stable or decrease, while the level of 1, 25(OH)2D remains normal. Supplementation with vitamin D results in an improvement in its serum concentration and positively affects bone mineral density, which is gradually reduced in post-gastrectomy survivors. Combining vitamin D supplementation with calcium and bisphosphonates enables us to obtain better results than vitamin D and calcium only. The type of surgery influences the level of serum vitamin D and its metabolites, with total or partial gastrectomy and maintenance of the duodenal food passage remaining the most important factors. There is a strong need for randomized, controlled trials that would investigate this matter in the future.

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“…In case of persistent chronic diarrhea limiting quality of life, symptomatic treatment with peristaltic inhibitors such as loperamide hydrochloride and probiotics should be considered. Similar to gastric resection, exocrine pancreatic insufficiency [85,86] may lead to maldigestion and malabsorption with consecutive steatorrhea, meteorism, and intolerance of Health-related quality of life after esophagectomy…”

Section: Nonspecific Postoperative Syndromesmentioning

confidence: 99%

Functional syndromes and symptom-orientated aftercare after esophagectomy

Ukegjini

Vetter

Fehr

et al. 2021

Langenbecks Arch Surg

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Background Surgery is the cornerstone of esophageal cancer treatment but remains burdened with significant postoperative changes of gastrointestinal function and quality of life. Purpose The aim of this narrative review is to assess and summarize the current knowledge on postoperative functional syndromes and quality of life after esophagectomy for cancer, and to provide orientation for the reader in the challenging field of functional aftercare. Conclusions Post-esophagectomy syndromes include various conditions such as dysphagia, reflux, delayed gastric emptying, dumping syndrome, weight loss, and chronic diarrhea. Clinical pictures and individual expressions are highly variable and may be extremely distressing for those affected. Therefore, in addition to a mostly well-coordinated oncological follow-up, we strongly emphasize the need for regular monitoring of physical well-being and gastrointestinal function. The prerequisite for an effective functional aftercare covering the whole spectrum of postoperative syndromes is a comprehensive knowledge of the pathophysiological background. As functional conditions often require a complex diagnostic workup and long-term therapy, close interdisciplinary cooperation with radiologists, gastroenterologists, oncologists, and specialized nutritional counseling is imperative for successful management.

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Nutritional deficiency post esophageal and gastric cancer surgery: A quality improvement study

Cited by 18 publications

References 15 publications

Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy

Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy

Vitamin D—The Nutritional Status of Post-Gastrectomy Gastric Cancer Patients—Systematic Review

Functional syndromes and symptom-orientated aftercare after esophagectomy

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