caa a22 4500 44533861X CHVBK 20180317142804.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1764-6 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1764-6 Oral Vitamin B12 Replacement: An Effective Treatment for Vitamin B12 Deficiency After Total Gastrectomy in Gastric Cancer Patients [Elektronische Daten] [Hyoung-Il Kim, Woo Hyung, Ki Song, Seung Choi, Choong-Bai Kim, Sung Noh] 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 (<200pg/ml) patients (n=30) received daily oral vitamin B12 (dosage: 1500μg mecobalamin) administration for 3months. 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: 1000μg cyanocobalamin) weekly for 5weeks and monthly thereafter for a total of 3months in a separate study period. Results: In both groups, mean serum vitamin B12 increased after 30days of treatment and was maintained up to 90days. 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. Society of Surgical Oncology, 2011 Kim Hyoung-Il Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut Hyung Woo Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut Song Ki Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea aut Choi Seung Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut Kim Choong-Bai Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut Noh Sung Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3711-3717 1068-9265 18:13<3711 2011 18 10434 https://doi.org/10.1245/s10434-011-1764-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1764-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kim Hyoung-Il Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Hyung Woo Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Song Ki Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Choi Seung Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Choong-Bai Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Noh Sung Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3711-3717 1068-9265 18:13<3711 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer