Oesophageal cancer: The effect of early nutrition support on clinical outcomes

Davies, Sarah; West, Malcolm; Rahman, S; Underwood, Tim; Marino, Luise V.

doi:10.1016/j.clnesp.2021.02.006

Cited by 20 publications

(10 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To avoid detrimental treatment outcomes because of weight loss or low pre-treatment weight, nutritional support should be provided to patients with esophageal cancer. Indeed, a study by Davies et al [ 18 ] reported that early nutritional support and intervention may be helpful in improving the overall condition of patients with esophageal cancer, as an increase in mortality has been noted in patients with severe weight loss (i.e., >10% of starting weight).…”

Section: Discussionmentioning

confidence: 99%

“…Ogino and Akiho [ 19 ] also noted that percutaneous feeding gastrostomy could be useful for nutritional support in esophageal cancer. Considering the above, further studies are required to determine whether alleviation of dysphagia by medical devices, such as stent insertion or feeding gastrostomy, improves the patient’s overall medical condition and nutritional status [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Low body mass index is associated with poor treatment outcome following radiotherapy in esophageal squamous cell carcinoma

Lee

2023

Radiat Oncol J

View full text Add to dashboard Cite

Purpose: We aimed to determine whether patients with esophageal cancer with a low baseline body mass index (BMI) have a poor prognosis following radiotherapy (RT).Materials and Methods: We retrospectively analyzed data from 50 patients with esophageal cancer to determine whether a low starting BMI (before RT) was associated with a poor outcome. All study participants were diagnosed with non-metastatic esophageal squamous cell carcinoma (SCC).Results: The number of patients at each T stage were as follows: 7 (14%) patients at T1, 18 (36%) at T2, 19 (38%) at T3, and 6 (12%) at T4. Based on BMI, 7 (14%) patients were defined as underweight. A low BMI was common in patients with T3/T4 stage esophageal cancer (7/43, p = 0.01). Overall, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 26.3% and 69.2%, respectively. In univariate analysis, clinical factors associated with poor PFS included being underweight (BMI <18.5 kg/m2; p = 0.011) and a positive N status (p = 0.017). Univariate analysis also revealed that being underweight was associated with a decrease in OS (p = 0.003). However, being underweight was not an independent prognostic factor for PFS and OS. Conclusion: Patients with esophageal SCC with a low starting BMI (BMI <18.5 kg/m2) are more prone to have a negative survival outcome following RT than patients who are considered to be normal weight or overweight. For this reason, it is important that clinicians pay more attention to BMI when treating patients with esophageal SCC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Low body mass index is associated with poor treatment outcome following radiotherapy in esophageal squamous cell carcinoma

Lee

2023

Radiat Oncol J

View full text Add to dashboard Cite

show abstract

“…In patients with esophageal cancer at a high risk of malnutrition, pre-operative weight loss ≥10% was associated with a higher risk of 1-year mortality regardless of the tumor stage, age, gender, and adjuvant treatment. In these patients, early nutrition support, defined as oral or enteral nutrition supplementation during neoadjuvant treatment, was associated with less weight loss at 12 months after surgery ( 61 ). In colorectal cancer patients undergoing surgery, who had a normal nutritional status and high risk of malnutrition assessed by measuring body composition, early peripheral parenteral nutrition led to a reduction of 15.4% of postoperative complications ( 62 ).…”

Section: Controversial Issues In Clinical Nutrition In Oncologymentioning

confidence: 99%

Malnutrition management in oncology: An expert view on controversial issues and future perspectives

et al. 2022

View full text Add to dashboard Cite

Cancer and anticancer treatments can lead to several negative side effects, including malnutrition. Despite the recognized need for adequate nutritional support in cancer patients, in daily clinical practice, nutrition is still not considered one of the first aspects to be considered. Malnutrition negatively affects the clinical outcomes, treatment response, and overall survival of cancer patients. In this study, three of the most controversial issues related to malnutrition, which emerged during an Italian Consensus Conference, were addressed specifically for patients with head and neck as well as gastrointestinal cancer. The timing of nutritional evaluation and intervention, extension of the Enhanced Recovery after Surgery (ERAS®) protocols, and cost-effectiveness of nutritional interventions have been considered. This study aimed to illustrate the state-of-the art of each issue and hypothesize future perspectives and actions to be taken, trying to suggest a new nutritional management model for cancer patients in Italy that overcomes the critical issues encountered. Of note, the timely diagnosis of nutritional issue appears to be essential to ensure the correct management of malnourished cancer patients as well as those who are at high risk of malnutrition. Standardized protocols, screening tests, and the inclusion of nutritional parameters in patient medical records would help to achieve good clinical outcomes. Finally, appropriate nutritional support is also associated with cost savings, and it seems necessary to promote its clinical and economic value to obtain improvements in both outcomes and management costs.

show abstract

“…A start of prehabilitation can already be considered with the start of neoadjuvant treatment. It was shown that early nutrition support during neoadjuvant treatment in patients with esophageal cancer leads to less weight loss at 12 months postoperatively [ 43 ]. A weight loss of ≥10% results in a significantly higher mortality.…”

Section: Prehabilitationmentioning

confidence: 99%

Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

Wobith

Weimann

2021

Nutrients

View full text Add to dashboard Cite

Nowadays, patients undergoing gastrointestinal surgery are following perioperative treatment in enhanced recovery after surgery (ERAS) protocols. Although oral feeding is supposed not to be stopped perioperatively with respect to ERAS, malnourished patients and inadequate calorie intake are common. Malnutrition, even in overweight or obese patients, is often underestimated. Patients at metabolic risk have to be identified early to confirm the indication for nutritional therapy. The monitoring of nutritional status postoperatively has to be considered in the hospital and after discharge, especially after surgery in the upper gastrointestinal tract, as normal oral food intake is decreased for several months. The article gives an overview of the current concepts of perioperative enteral nutrition in patients undergoing gastrointestinal surgery.

show abstract

Oesophageal cancer: The effect of early nutrition support on clinical outcomes

Cited by 20 publications

References 35 publications

Low body mass index is associated with poor treatment outcome following radiotherapy in esophageal squamous cell carcinoma

Low body mass index is associated with poor treatment outcome following radiotherapy in esophageal squamous cell carcinoma

Malnutrition management in oncology: An expert view on controversial issues and future perspectives

Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

Contact Info

Product

Resources

About