Highlights
- •This study evaluated the impact of nutrition interventions to control weight loss in upper gastrointestinal cancer patients.
- •Home enteral nutrition and nutritional counselling after major surgery are compared.
- •The effects of nutrition interventions are evaluated for 6 months.
- •Home enteral nutrition limited weight loss and increased the chance to complete chemotherapy.
Abstract
Background
Weight loss is frequent in patients with gastrointestinal (GI) cancer. Nutritional
status deteriorates throughout anti-cancer treatment, mostly after major surgery,
increasing complications, reducing tolerance and worsening the final prognosis. Enteral
nutrition is safe and effective in malnourished patients undergoing major GI surgery.
Randomised trials aimed at investigating the effects of home enteral nutrition (HEN)
in post-surgical patients with GI cancer are lacking. This study compares HEN and
counselling in limiting weight loss during oncologic treatment.
Patients and methods
Patients with upper GI cancer and candidate to major surgery were included in the
protocol when the nutritional risk screening (NRS 2002) score was ≥3. All patients
were supported with enteral nutrition through a jejunostomy after surgery and randomly
assigned to continue enteral nutrition or receiving nutritional counselling after
discharge. Nutritional and performance status, quality of life (QoL) and tolerance
to cancer treatment have been evaluated at 2 and 6 months after discharge.
Results
Seventy-nine patients were randomised; 38 continued enteral nutrition at home and
41 patients received nutritional counselling only. After 2 months, patients on HEN
maintained their mean body weight, while patients in the nutritional counselling group
showed a weight loss of 3.6 kg. Patients supported on HEN had a higher chance to complete
chemotherapy as planned (48% versus 34%). QoL was not worsened by HEN. No complications
were reported.
Conclusions
HEN is a simple and feasible treatment to support malnourished patients with upper
GI cancer after major surgery and during chemotherapy in order to limit further weight
loss.
Keywords
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Article info
Publication history
Published online: July 05, 2016
Accepted:
May 20,
2016
Received in revised form:
May 11,
2016
Received:
February 1,
2016
Identification
Copyright
Published by Elsevier Ltd.
