Vitamin D deficiency after gastrointestinal surgery - 2009
Vitamin D deficiency-incidence and response to oral supplementation among patients with various gastrointestinal malignancies.
2009 Gastrointestinal Cancers Symposium
Session Type and Session Title: General Poster Session F
Abstract No: 329
Author(s):C. Gilmore, J. James, B. Zubal, D. Thomas, B. R. Tan
| 25-OH vitamin D deficiency (%) amongst pts with GI cancers | ||||||
| (total n) | any def | severe | mod | mild | low-nl | nl |
| All, (202) | 87.6% | 17.8% | 43.6% | 26.2% | 11.4% | 1% |
| Male,(100) | 91% | 16% | 51% | 24% | 7% | 2% |
| Female, (102) | 85.2% | 19.6% | 36.3% | 28.4% | 15.6% | 0% |
| Age <65 (131) | 87% | 17.5% | 43.5% | 25.9% | 11.4% | 1.5% |
| Age >65 (71) | 88% | 18.3% | 43.6% | 26.8% | 11.3% | 0% |
| Colorectal (98) | 88.8% | 19.4% | 36.7% | 32.6% | 9.2% | 2% |
| Pancreatic (41) | 87.8% | 17.1% | 48.8% | 21.9% | 12.2% | 0% |
| Other (63) | 84.1% | 14.3% | 50.8% | 19% | 14.3% | 0% |
| Others: Other biliary (16), HCC (4), neuroendocrine (18), gastric (9), GIST (9), others (7) |
Introduction: Vitamin (vit) D deficiency is prevalent amongst patients (pts) with colorectal and pancreatic cancers.
Data for other GI malignancies are limited and the impact of short-course oral vit D supplementation is unclear.
Methods: An IRB-approved retrospective review of 202 pts with GI cancers from 12/2007 to 9/2008 was done to evaluate the incidence of vitamin D deficiency defined as serum 25-OH vit D levels of <30 ng/ml (severe <10 ng/ml; moderate=10-20 ng/ml; mild=21-30 ng/ml) and incidence of 'low-normal' (31-50 ng/ml) and normal (>50 ng/ml) vit D levels. Oral supplementation with vit D at 50,000 'u' weekly x 8-12 weeks were done and serum levels were redrawn at 2-3 months for pts with low normal and deficient vit D, respectively.
Results: 87.6% of all 202 pts is vit D deficient (61% severe to moderate). (see Table). 92 pts were re-evaluated after 2-3 months of oral vit D supplementation. Among this cohort, the incidence of pts with vitamin deficiency decreased from 91.3% to 57.6% after first re-evaluation. Severe/moderate deficiency rates also decreased from 71.7% to 13%. There were no significant difference in response between males/females, age < or >65, caucasian or non-caucasian or tumor type.
Conclusions: Vitamin D levels should routinely be evaluated for patients with GI maligancies. Oral supplementation decreases the rate 'any' vit D deficiency from 91% to 57%, and of 'severe to moderate' deficiency from 72% to 13%. Prospective studies on the impact of vit D deficiency and supplementation on various clinical outcomes among patients with GI cancers would improve supportive care management of these patients.