Klassen Diana, Strauch Carmen, Alteheld Birgit, Lingohr Philipp, Matthaei Hanno, Vilz Tim, Gonzalez-Carmona Maria A, Hausen Annekristin, Gräßler Marie, Sharma Amit, Strassburg Christian, Kalff Jörg C, Schmidt-Wolf Ingo G H
Center for Integrated Oncology (CIO), Department of Integrated Oncology, University Hospital Bonn, 53127 Bonn, Germany.
Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany.
Biomedicines. 2023 Feb 17;11(2):609. doi: 10.3390/biomedicines11020609.
The aim of this study was to investigate the effects of perioperative nutritional therapy care in gastrointestinal (esophageal, gastric, gastroesophageal) cancer patients on nutritional status and disease progression (complications, hospitalization, mortality). We considered 62 gastrointestinal cancer patients treated at the Center for Integrated Oncology (CIO), University Hospital Bonn, Germany (August 2017-July 2019). Of these, 42 patients (as intervention group: IG) received pre- and postoperative nutritional support with counseling, while 20 patients (as historical control group CG) received only postoperative nutritional therapy. Several clinical parameters, such as Body Mass Index (BMI), nutritional risk screening (NRS), phase angle, postoperative complications, length of hospital stay, and mortality, were determined. There were significantly fewer patients with gastric cancer/ gene mutation and more with esophageal cancer in IG ( = 0.001). Significantly more patients received neoadjuvant therapy in IG ( = 0.036). No significant differences were found between the groups regarding BMI, NRS, complications, length of hospital stay, and mortality. However, the comparison of post- and preoperative parameters in IG showed a tendency to lose 1.74 kg of weight ( = 0.046), a decrease in phase angle by 0.59° ( = 0.004), and an increase in NRS of 1.34 points ( < 0.001). Contrary to prior reports, we found no significant effect of perioperative nutritional therapy care in gastrointestinal cancer patients; however, the small cohort size and infrequent standardization in nutritional status may possibly account for the variance. Considering that oncological pathways and metabolic nutritional pathways are interrelated, dividing patients into subgroups to provide a personalized nutritional approach may help in improving their treatment.
本研究的目的是调查围手术期营养治疗护理对胃肠道(食管、胃、胃食管)癌患者营养状况和疾病进展(并发症、住院时间、死亡率)的影响。我们纳入了德国波恩大学医院综合肿瘤中心(CIO)治疗的62例胃肠道癌患者(2017年8月至2019年7月)。其中,42例患者(作为干预组:IG)接受了术前和术后营养支持及咨询,而20例患者(作为历史对照组:CG)仅接受术后营养治疗。测定了几个临床参数,如体重指数(BMI)、营养风险筛查(NRS)、相位角、术后并发症、住院时间和死亡率。IG组中胃癌/基因突变患者明显较少,食管癌患者较多(P = 0.001)。IG组中接受新辅助治疗的患者明显更多(P = 0.036)。两组在BMI、NRS、并发症、住院时间和死亡率方面未发现显著差异。然而,IG组术前和术后参数的比较显示,体重有减轻1.74 kg的趋势(P = 0.046),相位角降低0.59°(P = 0.004),NRS增加1.34分(P < 0.001)。与先前的报告相反,我们发现围手术期营养治疗护理对胃肠道癌患者没有显著影响;然而,样本量小和营养状况标准化不频繁可能是造成差异的原因。考虑到肿瘤学途径和代谢营养途径相互关联,将患者分为亚组以提供个性化营养方法可能有助于改善他们的治疗。