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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 defseveremodmildlow-nlnl
All, (202)87.6%17.8%43.6%26.2%11.4%1%
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.

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