430. MICRONUTRIENT INSUFFICIENCY AFTER SURGERY FOR OESOPHAGOGASTRIC NEOPLASMS: A PROSPECTIVE INTERVENTION STUDY NAMED THE VITAMIN STUDY

• Published in: Diseases of the esophagus 2022-09, Vol.35 (Supplement_2)
• Main Authors: Van der Velden, Ariadne Lisa, Vermeer, Thomas Adriaan, Boerma, Evert-Jan Gijsbert, Belgers, Eric Henricus Johannes, Stoot, Jan Henri Marie Basile, Leers, Mathie Peter Gertruda, Sosef, Meindert Nico, Vijgen, Guy Hubertus Elisabeth Joseph
• Format: Article
• Language: English
• ISSN: 1120-8694; 1442-2050
• DOI: 10.1093/dote/doac051.430

Oesophageal and gastric cancer are among the top ten cancers worldwide. Both diseases have major impact on the nutritional status and quality of life (QoL). Preoperative malnutrition is reported in 42–80%. However, studies investigating postoperative nutritional status are scarce and postoperative identification and treatment of micronutritional deficiencies are currently lacking in (inter-)national guidelines. The aim of this study is to identify and target micronutrient deficiencies after surgery for oesophageal or gastric neoplasms. This is a single centre prospective intervention trial with inclusion of 248 patients who underwent oesophagectomy (n = 124) or (sub)total gastrectomy (n = 124). Patients will receive a tailormade multivitamin supplement which differs per group and additionally a calcium supplement. Baseline measurements consist of blood withdrawal, faecal elastase-1 analysis, QoL and dietary behaviour. After 6, 12 and 24 months from baseline, measurements are repeated, and a supplement questionnaire is added. The primary objective is micronutrient deficiency (yes/no). Secondary objectives include occurrence and symptoms of pancreas insufficiency (n, %), time between surgery and start of supplementation (mean in months) and QoL at all time points. Inclusion started in December 2021 and is still recruiting. Currently, preliminary results of 40 included patients are available, whereby 24 patients underwent oesophagectomy and 16 patients underwent gastrectomy (table 1). In this population, 87.5% developed at least one micronutrient deficiency, equally seen per subgroup. The most profound deficiencies found are vitamin D (55.0%), ferritin (40.0%), Iron (32.5%), zinc (22.5%). Other deficiencies found are folic acid (12.5%), calcium (7.5%), vitamin B6 (5.0%) and vitamin B12 (2.5%). Decreased faecal elastase-1 (< 200 mg/kg) was found in 15% of the total population. Literature regarding the incidence of micronutrient deficiencies and supplementation after oesophageal and gastric surgery is scarce. If micronutrient deficiencies are significantly present in this population and daily supplementation can prevent and resolve these deficiencies, routine monitoring and supplementation of micronutrient deficiencies can be implemented in the standard postoperative care of oesophageal and gastric surgery.