Impact of home enteral nutrition in malnourished patients with upper gastrointestinal cancer: A multicentre randomised clinical trial

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 effec...

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Bibliographic Details
Published in:European journal of cancer (1990) 2016-09, Vol.64, p.107-112
Main Authors: Gavazzi, Cecilia, Colatruglio, Silvia, Valoriani, Filippo, Mazzaferro, Vincenzo, Sabbatini, Annarita, Biffi, Roberto, Mariani, Luigi, Miceli, Rosalba
Format: Article
Language:English
Subjects:
Aged
Body Weight
Counseling - methods
Digestive System Surgical Procedures
Enteral Nutrition - methods
Female
Gastrointestinal cancer
Gastrointestinal Neoplasms - complications
Gastrointestinal Neoplasms - surgery
Hematology, Oncology and Palliative Medicine
Home Care Services
Home enteral nutrition
Humans
Male
Malnutrition
Malnutrition - etiology
Malnutrition - therapy
Middle Aged
Nutritional counselling
Nutritional Status
Quality of Life
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Summary: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.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2016.05.032