Effects of Immunonutrition on Cancer Patients Undergoing Surgery: A Scoping Review

Abstract

Introduction: There is a large body of evidence about immunonutrition formulas; however, there are still doubts about their usefulness in routine clinical practice as compared with standard formulas. In the age of personalized medicine, new studies appear every year regarding several types of patients; therefore, an updated point of view on these formulas is necessary. Methods: The Embase database was searched from 2016 to 14 March 2022. Our criteria were articles published in English and Spanish. The evidence quality was evaluated using GRADEpro, and the review was developed according to the PRISMA statement. Results: In this review, a total of 65 unique records were retrieved; however, 36 articles did not meet the inclusion criteria and were thus excluded. In total, 29 articles were included in the final analysis. In the last few years, many meta-analyses have attempted to identify additional existing studies of surgical patients with certain pathologies, mainly oncological patients. Immunonutrition prior to oncological surgery was shown to cause a decrease in inflammatory markers in most of the studies, and the main clinical events that changed were the infectious complications after surgery. The length of stay and mortality data are controversial due to the specific risk factors associated with these events. Conclusions: The use of immunonutrition in patients who have undergone oncological surgery decreases the levels of inflammatory markers and infectious postoperative complications in almost all localizations. However, more studies are needed to assess the use of immunonutrition based on Enhanced Recovery After Surgery (ERAS) protocols.

Mapping the landscape of immunonutrition and cancer research: A comprehensive bibliometric analysis on behalf of NutriOnc Research Group

“…The findings from this analysis align with existing literature, revealing an increasing research output, multidisciplinary collaborations, and emerging thematic areas of investigation in this field 6 , 7 . The observed increase in the number of publications on immunonutrition and cancer over time is indicative of the growing recognition of the pivotal role that nutrition and immune function play in cancer biology and treatment 9 – 11 . This trend is consistent with the broader understanding of the complex interplay between host immune responses and cancer progression 12 .…”

“…The wide and different range of journals publishing on this topic, with ʻClinical Nutritionʼ emerging as the top source, indicates the multidisciplinary nature of immunonutrition research. This finding suggests that experts from various disciplines, including clinical nutrition, oncology, radiotherapy, and surgical oncology, are actively engaged in resolving the intricate connections between nutrition, immune function, and cancer outcomes 6 , 9 – 11 , 16 . Such collaboration enhances the breadth and depth of research conducted in this field.…”

“…Immunonutrition, an emerging field at the interface of immunology and nutrition, focuses on the impact of specific nutrients on immune system modulation 8 . Understanding the profound influence of immunonutrition on cancer development, progression, and therapeutic interventions holds exceptional promise in revolutionizing cancer research and clinical practice 9 – 11 .…”

Efficacy of a new immunonutrition formula with extra virgin olive oil in the reduction of complications in surgeries of upper digestive tract tumors

“…Immunonutrition (IN) is a nutritional treatment focused on: (a) modulating the inflammatory response; (b) stimulating immune function; (c) supporting intestinal trophism; and (d) reducing postoperative morbidity ( 7 ). There are several nutrients with immunomodulatory functions.…”

Efficacy of immune nutrients in severe acute pancreatitis: A network meta-analysis

“…They also enhance immunity, regulate the inflammatory response, and serve as antioxidants. [ 9 , 10 ] However, differences exist among immune nutrients. The excessive intake of some immune nutrients, such as glutamine and arginine, which are amino acids, may incur adverse effects on patients with poor kidney functions.…”