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Oral vitamin B12 replacement: an effective treatment for vitamin B12 deficiency after total gastrectomy in gastric cancer patients.

Authors
 Hyoung-Il Kim  ;  Woo Jin Hyung  ;  Ki Jun Song  ;  Seung Ho Choi  ;  Choong-Bai Kim  ;  Sung Hoon Noh 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.18(13) : 3711-3717, 2011 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2011
MeSH
Administration, Oral ; Biological Availability ; Female ; Follow-Up Studies ; Gastrectomy/adverse effects* ; Humans ; Male ; Middle Aged ; Postoperative Complications* ; Prognosis ; Prospective Studies ; Stomach Neoplasms/complications ; Stomach Neoplasms/surgery* ; Vitamin B 12/administration & dosage* ; Vitamin B 12/analogs & derivatives* ; Vitamin B 12 Deficiency/drug therapy* ; Vitamin B 12 Deficiency/etiology
Keywords
Homocysteine ; Gastric Cancer Patient ; Total Gastrectomy ; Serum Vitamin ; Mean Corpuscular Volume
Abstract
BACKGROUND: Vitamin B12 deficiency is a common long-term sequelae after total gastrectomy. Intramuscular injection of vitamin B12 is the only known treatment. We investigated the efficacy and safety of oral vitamin B12 replacement for gastric cancer patients with vitamin B12 deficiency after total gastrectomy.

METHODS: We performed a single-arm, open-label, fixed-drug dosage, prospective study (NCT00699478) involving gastric cancer patients who underwent total gastrectomy. Vitamin B12-deficient (<200 pg/ml) patients (n = 30) received daily oral vitamin B12 (dosage: 1500 μg mecobalamin) administration for 3 months. The primary outcome measurement was serum vitamin B12. The secondary outcome measurements were improvement of neurologic symptoms and hematologic findings (serum folate, homocysteine, ferritin, iron, total iron binding capacity, transferrin, and mean corpuscular volume). For comparison, another group of vitamin B12 deficient patients (n = 30) received intramuscular vitamin B12 injections (dosage: 1000 μg cyanocobalamin) weekly for 5 weeks and monthly thereafter for a total of 3 months in a separate study period.

RESULTS: In both groups, mean serum vitamin B12 increased after 30 days of treatment and was maintained up to 90 days. No adverse effects related to oral or intramuscular vitamin B12 replacements were noted. Both groups showed decreased homocysteine levels. Before treatment, 29 patients in the oral vitamin B12 group had neurologic symptoms related to vitamin B12 deficiency. After oral vitamin B12 treatment, 28 patients experienced symptom relief, and 16 patients were symptom free.

CONCLUSIONS: Oral vitamin B12 replacement is an effective and safe treatment for vitamin B12 deficiency in gastric cancer patients after total gastrectomy.
Full Text
http://link.springer.com/article/10.1245%2Fs10434-011-1764-6
DOI
10.1245/s10434-011-1764-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Choong Bai(김충배)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Song, Ki Jun(송기준) ORCID logo https://orcid.org/0000-0003-2505-4112
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94963
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