Impact of Preoperative Short‐Term Parenteral Nutrition Support on the Clinical Outcome of Gastric Cancer Patients: A Propensity Score Matching Analysis

Abstract

Objectives: Nutrition status is of great significance to the clinical outcome after major abdominal surgery. However, the effect of preoperative short-term parenteral nutrition (PN) support among gastric cancer (GC) patients remains unknown and was evaluated in the current study. Methods: We retrospectively analyzed 455 nutritionally at-risk GC patients after radical resection from 2010 to 2016. We matched patients with 3-7 days of PN support to those without PN support. χ 2 And Mann-Whitney U tests were used to compare differences between the PN and control groups. Results: The propensity-matched sample included 368 GC patients (PN group, n = 184; control group, n = 184). The PN and control groups did not differ regarding postoperative complications (P = .528). The incidence of anastomotic leakage in the PN group was lower than in the control group (P = .011), whereas other complications were not found to differ between the groups. The hospitalization cost of the PN group was significantly higher than that of the control group (P < .001), whereas other outcome indicators were similar. Subgroup analysis showed that short-term PN support may have an improved benefit for patients with serum albumin level <35 g/L, but not at the level of statistical significance (P = .17). Conclusion: Short-term PN support did not significantly improve the short-term clinical outcomes of nutritionally at-risk GC patients, with the exception of a lower incidence of anastomotic leakage. Considering that short-term PN support increases economic burden, PN should not be the preferred method among these patients.

Lack of clinical benefit from preoperative short-term parenteral nutrition on the clinical prognosis of patients treated with radical gastrectomy for gastric cancer: a two-center retrospective study based on propensity score matching analysis

“…PN did not affect long-term survival (P=0.950) regardless of whether patients were grouped according to SMI, TNM stage, or tumor differentiation. Huang et al and Xu et al demonstrated that short-term preoperative PN (3–7 days) did not significantly improve the prognosis of patients with GC at high risk of malnutrition or sarcopenia ( 21 , 22 ), which is similar to our results. We also found no significant effect of short-term preoperative PN on long-term survival (P=0.950).…”

“…In addition, as opposed to EN, PN is less commonly used by surgeons because it is less incompatible with human physiology ( 6 ). Studies have shown that the prevalence of postoperative complications decreases in malnourished patients with longer preoperative PN (≥7 days) ( 9 ), whereas it did not decrease with short-term PN ( 21 , 22 ). In fact, patients receiving PN therapy are not limited to those who are malnourished.…”

Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer

“…Nutritional care is an integral component of multi-disciplinary anti-cancer treatments, and has been shown to optimize the clinical outcomes for patients with various cancers (6)(7)(8)(9) . Malnutrition frequently develops in oncology patients due to either the tumor itself or various anti-cancer treatments, and can lead to poorer clinical outcomes (6) .…”

Reducing the Risk of Gastric Cancer Through Proper Nutrition – A Meta-Analysis

“…Weight loss is common in people, and it can happen anywhere from 31% to 85% of the time, depending on the type of cancer. People with GC lost more than 5 percent of their weight, according to [20] [21].…”

“…Quality of life is a vague term that means different things to different people. The term is still being debated today [21]. One way to think about this is to make a person important, meaningful, and happy in life.…”