Cost-Effectiveness of Perioperative Immunonutrition in Gastrointestinal Oncologic Surgery: A Systematic Review

Reis, Audrey Machado dos; Kabke, Geórgia Brum; Fruchtenicht, Ana Valéria Gonçalves; Barreiro, Taiane Dias; Moreira, Luís Fernando

doi:10.1590/0102-6720201600020014

Cited by 9 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No significant effect of immunonutrition on other postoperative morbidities and mortality was noticed [86]. The reduction in hospital stay and/ or in postoperative complications seems to compensate for the higher cost of immunonutrition compared to standard enteral feeding in a cost-effectiveness analysis [87]. According to ESPEN guidelines on nutrition in cancer patients, upper gastrointestinal tract cancer patients undergoing surgical resection should receive oral/enteral immunonutrition in the context of traditional perioperative care [79].…”

Section: Esophageal Abnormalitiesmentioning

confidence: 99%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

View full text Add to dashboard Cite

Esophageal cancer is associated with malnutrition in the vast majority of patients. This phenomenon is partly attributed to the disease process itself, the location of the tumor and other factors, such as dysphagia which is often accentuated due to chemotherapy/ radiotherapy treatment or surgical intervention. The poor nutritional status of these patients is often related to the presence of cancer cachexia, altered metabolism, and tissue wasting. Malnutrition in this patient population affects quality of life, worsens patient's tolerance to chemotherapy and accounts for lower survival. Nutritional management of these patients includes both proper nutritional assessment and support and might prevent, to a certain extent, the manifestation of malnutrition-related consequences. The purpose of this article is to review the current literature in order to focus on the etiology and diagnosis of malnutrition in esophageal cancer patients, emphasizing also on the optimal nutritional support during multimodality treatment.

show abstract

Section: Esophageal Abnormalitiesmentioning

confidence: 99%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

View full text Add to dashboard Cite

show abstract

“…First, our study is the first cost-effectiveness analysis of sHPN for incurable gastrointestinal cancer patients. Previous economic analyses of nutrition support mainly focused on the effect indexes such as changes in hospitalization stays, complication rates, and related markers ( 26 ). Our study conducted cost-effectiveness analyses from multiple dimensions by evaluating sHPN on both long-term survival and short-term objective indicators, which provided nutritional options for clinical practice in China.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analyses of Home Parenteral Nutrition for Incurable Gastrointestinal Cancer Patients

Guo

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundAppropriate nutritional support, including supplemental home parenteral nutrition (sHPN), may improve prognosis and quality of life (Qol) of malnourished cancer patients. We aimed to explore the cost-effectiveness of sHPN for incurable gastrointestinal cancer patients from the Chinese healthcare perspective.MethodClinical data were extracted from a randomized controlled trial (NCT02066363). Patients were randomized into the sHPN group or the non-sHPN group (receiving best practice nutritional care). A Markov model was established with a 6-week cycle length. Costs were acquired from local hospitals, effect parameters included quality-adjusted life year (QALY), Qol, body mass index, fat-free mass (FFM), FFM index, handgrip strength, and a 6-min walking test. Sensitivity analyses were conducted with a willingness-to-pay (WTP) set at 3 per capita gross domestic product ($29,307/QALY).ResultsWhen considering QALY as a utility, the incremental cost-effectiveness ratio (ICER) was $24,289.17, with an incremental cost of $2,051.18 and an incremental QALY of 0.0844 between the sHPN group and the non-sHPN group. Furthermore, we explored the cost-effectiveness of sHPN from multidimensions, where we analyzed various effect parameters at different visits; the results showed a superior benefit for patients in the sHPN group except for the handgrip parameter at visit 2. Sensitivity analysis demonstrated the influence of utilities in the sHPN group, but the sHPN group was still cost-effective with a WTP of $2,500/QALY.ConclusionIn China, sHPN was cost-effective for patients with incurable gastrointestinal cancer, which suggested further applications in clinical practice and provided references for clinical decisions and pricing.

show abstract

“…Three meta-analyses and systematic reviews investigated the effects of immunonutrition in patients with various gastrointestinal cancers; in two of them, immunonutrition had effects not only on the rates of infectious complications and length of hospitalisation, but also on the overall complication rates [29,30]. Immunonutrition was found to be cost-effective in surgical patients with gastrointestinal cancers (i.e., this intervention may reduce treatment costs because of the lower complication rates) [24].…”

Section: Discussionmentioning

confidence: 99%

Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy

et al. 2020

View full text Add to dashboard Cite

Background and objectives: Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5–7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the overall complication rate are contradictory and it is not clear, which groups of patients benefit most. The aims of this study are to evaluate the effects of immunonutrition on the overall complication rate and the rate of severe and/or multiple complications in patients with pancreatic tumours stratified according to final histological diagnosis—patients with pancreatic ductal adenocarcinoma (PDAC) vs. other tumours—and nutritional state, using more sensitive Comprehensive Complication Index. Materials and Methods: Seventy consecutive patients scheduled for pancreatoduodenectomy because of pancreatic tumours were randomised into immunonutrition vs. control groups and stratified according to final histological diagnosis and nutritional status. Surgical outcomes were assessed postoperatively using Clavien—Dindo classification (CDC) and Comprehensive Complication Index (CCI). Results: No significant differences in the overall complication rates in immunonutrition vs. control, patients with malnutrition vs. no malnutrition, PDAC vs. other pancreatic tumours groups were detected. However, significant differences in the rates of severe and/or multiple complications in immunonutrition vs. control groups and in PDAC patients segregated according to immunonutrition were obtained using CCI. Conclusions: Patients with PDAC may experience greater benefits of immunonutrition as compared to patients with benign pancreatic diseases or less aggressive tumours, while nutritional status was not a determining factor for the efficacy of immunonutrition.

show abstract

Cost-Effectiveness of Perioperative Immunonutrition in Gastrointestinal Oncologic Surgery: A Systematic Review

Cited by 9 publications

References 20 publications

Nutritional Management of Esophageal Cancer Patients

Nutritional Management of Esophageal Cancer Patients

Cost-Effectiveness Analyses of Home Parenteral Nutrition for Incurable Gastrointestinal Cancer Patients

Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy

Contact Info

Product

Resources

About