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Aim To investigate the role of micronutrient deficiencies in patients undergoing an esophagectomy for cancer. Background & Methods Over the past decades survival rates for patients with resectable esophageal cancer have improved significantly. Consequently, the sequelae of having a gastric conduit such as development of micronutrient deficiencies become increasingly important. For this study, a systematic search of the literature was conducted, and postoperative hematological and nutritional parameters in the follow-up of patients that participated in the NUTRIENT II trial between October 2015 and May 2018 at the Catharina Hospital were investigated. Patients were included if they had at least one postoperative value for either iron, ferritin, vitamins B1, B6, B12, D, folic acid or methylmalonic acid. Results Data was available in 83 of 95 patients. Of these, 78.3% (65/83) had at least one and 37.3% (31/83) had more than one micronutrient deficiency at a median of 6.1 months (interquartile range 5.4-7.5) after surgery. Similar to the results found in previous studies, deficiencies included iron (including ferritin) in 42.2% (27/64), vitamin B12 (including methylmalonic acid) in 18.3% (15/82) and vitamin D in 50.6% (41/81) of patients, respectively. Moreover, folic acid deficiency was present in 28.8% (23/80) of patients. Anemia was present in 32% (16/50) of patients. At 24.8 months (interquartile range 19.4-33.1) after surgery, most micronutrient deficiencies normalized following supplementation. Conclusion Micronutrient deficiencies are common in patients as early as six months following an esophagectomy. Therefore, these patients should be routinely checked and supplementation provided when needed.

Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) Checklist APPIC trial. (PDF 129Â kb)

Subject information and consent form (in Dutch). (PDF 231Â kb)