Vitamin D deficiency in patients operated on for gastric lymphoma.
OBJECTIVE
To determine the nutritional status in patients treated for gastric non-Hodgkin's lymphoma (NHL).


METHODS
Patients treated during the period 1990-99 according to a protocol including primary gastric surgery for eligible patients were registered prospectively in successive patients. Those with aggressive lymphomas in stage IE-IIE underwent gastric surgery followed by CHOP-like chemotherapy. Patients with indolent lymphomas and localized disease did not receive any further treatment if the operation was considered radical; otherwise, they received local radiotherapy after surgery. Patients with advanced disease underwent gastric surgery only if there was a considerable risk of bleeding or perforation. Patients below the age of 80 years and in complete remission were offered a cross-sectional examination a median of 102 months later, including clinical examination with estimation of body mass index, upper endoscopy and blood tests (haemoglobin, ferritin, serum-Fe, total iron-binding capacity (TIBC), vitamin B(12), homocysteine, vitamin D status, parathyroid hormone (PTH), albumin and electrolytes).


RESULTS
Forty patients were identified, of whom 33 met for follow-up examination. Seventeen patients had a partial gastrectomy (PG), 9 a total gastrectomy (TG) and 7 patients were not operated on. The patients in the TG group had significant weight loss. Furthermore, the patients in the TG group had a lower storage iron content (s-ferritin and s-iron saturation), lower s-vitamin D, higher s-PTH and homocysteine than the other groups.


CONCLUSIONS
If surgery is necessary for gastric lymphomas, a PG should be performed when possible. The patients should receive dietary advice and be followed-up at least yearly for nutritional deficiencies. Regular intake of vitamin D and -B(12), calcium, folate and iron should be considered.
Hollender
Ase
A
Department of Medical Oncology, The Norwegian Radium Hospital, Montebello, Oslo, Norway.
Bjøro
Trine
T
Otto Karlsen
Karl
K
Kvaloy
Stein O
SO
Nome
Ole
O
Holte
Harald
H
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009752:Nutritional Status; D011446:Prospective Studies; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D014808:Vitamin D Deficiency / Q000097:blood*