Intake and Nutritional Adequacy in Patients With Cancer Diagnosed With Malignant Bowel Obstruction: A Secondary Analysis of a Randomized Trial.

BACKGROUND

Malignant bowel obstruction (MBO) is experienced by many with advanced cancer. Patients with MBO cannot eat and may have reduced ability to eat once the acute process has resolved. Sparse data exist to describe oral intake capacity and adequacy of nutrition in patients with MBO. These data are critical to developing effective supportive care nutrition therapy for patients with MBO.

OBJECTIVE

The aim of this study was to describe the ability to consume food and liquids orally, estimating nutritional adequacy of diet in a sample of patients who received surgical or nonsurgical treatment for MBO.

DESIGN

A descriptive secondary data analysis of repeated dietary intake measures from S1316, a pragmatic comparative effectiveness trial of surgical and nonsurgical treatment for MBO. Participant enrollment occurred between 2015 and 2020. Ability to eat was assessed through self-reported telephone survey and intake was estimated using telephone-based 24-hour recalls, applying US Department of Agriculture multipass methodology.

PARTICIPANTS/SETTING: The primary trial was conducted within the SWOG Cancer Research Network and included recruitment sites across the United States and Latin America. Eligible participants were diagnosed with, and hospitalized for, MBO.

MAIN OUTCOME MEASURES

The main outcomes measures were self- or caregiver-reported ability to eat, as well as overall nutrient intake.

STATISTICAL ANALYSIS

Descriptive statistics were used to report patient characteristics, intake, and nutrient adequacy. Nutrient intake was presented by tertiles of gastrointestinal symptom severity and assessed.

RESULTS

Two hundred twenty-one participants were registered; 199 were eligible and included. At week 1, 51% of patients with MBO reported consuming some solid food orally; 34% reported no oral intake; and 13% were on enteral feeding only. For patients alive and responsive to recalls at 13 weeks (n = 57), 82% (n = 47) reported consuming solid food. Compared with recommendations, mean reported intake was inadequate for most nutrients.

CONCLUSIONS

Oral intake is reported in more than one-half of patients diagnosed with MBO. Medical nutrition therapy should be tailored to patient's tolerance for eating and with consideration or patient's desire to address nutritional inadequacies.