A Narrative Review of Nutritional Therapy for Gastrointestinal Cancer Patients Underwent Surgery

Zhang, Yujie; Zhang, Jinglin; Zhu, Lili; Hao, Jiaqi; He, Feng-Jun; Xu, Tao; Wang, Rui; Zhuang, Wen; Wang, Mo-Jin

doi:10.1080/08941939.2022.2150337

Cited by 8 publications

(4 citation statements)

References 75 publications

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“…EN/PN should be considered if it can improve systemic therapy outcomes and promote better symptom management. EN/PN should also be considered in patients who are severely malnourished as a result of uncontrolled disease to improve QoL, nutritional, and functional status [43,44]. Peritoneal involvement is often associated with malnutrition and an inability to tolerate EN, making these patients candidates for PN (EN is preferred to PN as it is less invasive and mimics the normal physiological process).…”

Section: Peritoneal Involvement and Artificial Nutrition Support Usin...mentioning

confidence: 99%

Best Practices for Managing Patients with Unresectable Metastatic Gastric and Gastroesophageal Junction Cancer in Canada

Snow,

Gabrielson,

Lim

et al. 2024

Current Oncology

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Gastric cancer (GC) is one of the most common types of cancer and is associated with relatively low survival rates. Despite its considerable burden, there is limited guidance for Canadian clinicians on the management of unresectable metastatic GC and gastroesophageal junction cancer (GEJC). Therefore, we aimed to discuss best practices and provide expert recommendations for patient management within the current Canadian unresectable GC and GEJC landscape. A multidisciplinary group of Canadian healthcare practitioners was assembled to develop expert recommendations via a working group. The often-rapid progression of unresectable GC and GEJC and the associated malnutrition have a significant impact on the patient’s quality of life and ability to tolerate treatment. Hence, recommendations include early diagnosis, identification of relevant biomarkers to improve personalized treatment, and relevant support to manage comorbidities. A multidisciplinary approach including early access to registered dietitians, personal support networks, and palliative care services, is needed to optimize possible outcomes for patients. Where possible, patients with unresectable GC and GEJC would benefit from access to clinical trials and innovative treatments.

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Section: Peritoneal Involvement and Artificial Nutrition Support Usin...mentioning

confidence: 99%

Best Practices for Managing Patients with Unresectable Metastatic Gastric and Gastroesophageal Junction Cancer in Canada

Snow,

Gabrielson,

Lim

et al. 2024

Current Oncology

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“…Many research advances have been reported for the benefits of using immunonutrition, like omega-3 fatty acids, nucleotide, arginine, and glutamine for cancer patients during perioperative management. Evidence indicates that these modalities can significantly enhance inflammatory and host immune system responses [ 94 , 95 ]. Moreover, more research shows the advantages of using immunonutrition with enteral and oral formulas.…”

Section: Comparing Enteral and Parenteral Nutritionmentioning

confidence: 99%

Nutritional care in patients undergoing laparoscopic/minimally invasive surgeries for gastrointestinal tumours.

Xuefen,

Yuanyuan,

Qin

et al. 2023

Videosurgery and Other Miniinvasive Techniques

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The introduction of minimally invasive surgeries for gastrointestinal tumours has been associated with many favourable postoperative outcomes and a reduced impact on nutritional status. The literature review begins by discussing the impact of minimally invasive procedures on the nutritional status of patients with gastrointestinal tumours, followed by indications for enteral nutrition (EN) in this population, including preoperative nutritional support and postoperative nutritional support. The review then examines the evidence that favours the use of EN in this population, including studies demonstrating improved outcomes with preoperative EN and reduced postoperative complications with postoperative EN. It also discusses potential strategies for improving outcomes with EN, such as early initiation of feeding and individualized nutrition plans. Overall, current evidence shows that EN improves outcomes, reduces complications, and enhances the quality of life. However, the optimal timing, composition of EN, and long-term outcomes are still unclear, indicating the need for future investigations.

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“…Arginine exhibits several immunostimulatory effects, such as promoting the proliferation of T lymphocytes and enhancing the functional capabilities of macrophages and natural killer cells [17]. Omega-3 fatty acids are a subgroup of polyunsaturated fatty acids that primarily consist of α-linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid [18]. The presence of ω-3 fatty acids decreases the production of pro-inflammatory cytokines, such as IL-1β, IL-6, and TNF-α, and increases the secretion of anti-inflammatory factors, such as IL-10 and prostaglandin D3 [18], which can impede the adhesion of lymphocytes to monocytes and diminish antigen-stimulated lymphocyte proliferation [17,19].…”

Section: Mechanisms Of Action Of the Arginine ω-3 Fatty Acids And Nuc...mentioning

confidence: 99%

“…Omega-3 fatty acids are a subgroup of polyunsaturated fatty acids that primarily consist of α-linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid [18]. The presence of ω-3 fatty acids decreases the production of pro-inflammatory cytokines, such as IL-1β, IL-6, and TNF-α, and increases the secretion of anti-inflammatory factors, such as IL-10 and prostaglandin D3 [18], which can impede the adhesion of lymphocytes to monocytes and diminish antigen-stimulated lymphocyte proliferation [17,19]. Nucleotides and their metabolites can stimulate lymphocyte proliferation, which also impacts the immune function of macrophages and natural killer cells [17].…”

Section: Mechanisms Of Action Of the Arginine ω-3 Fatty Acids And Nuc...mentioning

confidence: 99%

Role of preoperative immunonutrition in patients with colorectal cancer: a narrative review

Lee,

Park,

Kim

et al. 2023

Ann Clin Nutr Metab

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Purpose: Colorectal cancer surgery presents challenges due to surgical stress and immunosuppression, leading to postoperative complications. Nutrition is crucial for colorectal cancer patients who are prone to malnutrition. This study aims to provide a comprehensive review of the role of preoperative immunonutrition in colorectal cancer surgery. Current concept: Preoperative immunonutrition, consisting of immunonutrients such as arginine, ω-3 fatty acids, and nucleotides, has emerged as a potential strategy to enhance surgical outcomes by modulating immune responses and reducing complications. Current guidelines recommend preoperative oral nutritional supplements for major abdominal surgery and immunonutrition for nutritionally high-risk patients. Meta-analysis have demonstrated significant decreases in infectious complications and hospital stay durations with preoperative immunonutrition. However, limitations such as publication bias and heterogeneity in the previous studies should be considered. Further research should focus on the optimal timing, duration, and amount of immunonutrition; the patient populations that would benefit most; and the integration of immunonutrition into enhanced recovery after surgery protocols. Conclusion: While preoperative immunonutrition shows promise, additional research is crucial to refine protocols and establish optimal clinical practice utilization.

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A Narrative Review of Nutritional Therapy for Gastrointestinal Cancer Patients Underwent Surgery

Cited by 8 publications

References 75 publications

Best Practices for Managing Patients with Unresectable Metastatic Gastric and Gastroesophageal Junction Cancer in Canada

Best Practices for Managing Patients with Unresectable Metastatic Gastric and Gastroesophageal Junction Cancer in Canada

Nutritional care in patients undergoing laparoscopic/minimally invasive surgeries for gastrointestinal tumours.

Role of preoperative immunonutrition in patients with colorectal cancer: a narrative review

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