Colorectal Cancer: Open Access

Vitamin B12 Status after Right Hemicolectomy in Bowel Cancer Patients: A Feasibility Study

Introduction: Terminal ileum resection in patients with Crohn’s disease results in vitamin B₁₂ deficiency and these patients are routinely given B₁₂ supplementation to prevent anemia and neuropsychiatric disease. The effect of right hemicolectomy on B₁₂ status in cancer patients has not previously been studied. Total serum B₁₂ is an unreliable test. Second-line diagnostic tests measure methylmalonic acid (MMA) and homocysteine (tHcy) are also used. An assay measuring an active form of B₁₂ is available for routine use. This observational study investigated whether B₁₂ deficiency exists in patients after a right hemicolectomy for cancer.

Methods: Patients (n=28; age range=52-88 years) who had undergone a right hemicolectomy for cancer and been in remission for two years were identified from a database and recruited to an outpatient clinic along with an age-matched control group (n=27; age range=52-89 years). Vitamin B₁₂ status in both patients and controls was assessed by the measurement of vitamin B₁₂ (total and active), MMA and tHcy.

Results: Concentration of tHcy was significantly higher (p<0.05) in the surgical group (14.0 μmol/L) compared with the controls (11.1 μmol/L). There were no significant differences in total and active B₁₂, folate and MMA concentrations between the two groups (p>0.05).

Discussion: Right hemicolectomy for malignancy is associated with an increase in tHcy concentrations although a larger study is required to determine the B₁₂ status in post-operative right hemicolectomy patients.

Author(s):

Williams A*, Basu P, Hughes L, Mard D, Edwards P, Carter J and Williams EM

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