Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: Secondary analysis of a prospective randomized trial.

Bargetzi, L; Brack, C; Herrmann, J; Bargetzi, A; Hersberger, L; Bargetzi, M; Kaegi-Braun, N; Tribolet, P; Gomes, F; Hoess, C; Pavlicek, V; Bilz, S; Sigrist, S; Brändle, M; Henzen, C; Thomann, R; Rutishauser, J; Aujesky, D.; Rodondi, N.; Donzé, J.; ... (2021). Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: Secondary analysis of a prospective randomized trial. Annals of oncology, 32(8), pp. 1025-1033. Elsevier 10.1016/j.annonc.2021.05.793

Preview	Text Bargetzi_AnnOncol_2021_AAM.pdf - Accepted Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (1MB) | Preview
	Text Bargetzi_AnnOncol_2021.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (359kB)

INTRODUCTION

Nutritional support in patients with cancer aims at improving quality of life. Whether use of nutritional support is also effective in improving clinical outcomes remains understudied.

METHODS

In this preplanned secondary analysis of patients with cancer included in a prospective, randomized-controlled, Swiss, multicenter trial (EFFORT), we compared protocol-guided individualized nutritional support (intervention group) to standard hospital food (control group) regarding mortality at 30-day (primary endpoint) and other clinical outcomes.

RESULTS

We analyzed 506 patients with a main admission diagnosis of cancer, including lung cancer (n=113), gastrointestinal tumors (n=84), hematological malignancies (n=108) and other types of cancer (n=201). Nutritional risk based on Nutritional Risk Screening [NRS 2002] was an independent predictor for mortality over 180 days with a (age-, sex-, center-, type of cancer-, tumor activity- and treatment-) adjusted hazard ratio of 1.29 (95% CI 1.09 to 1.54; p=0.004) per point increase in NRS. In the 30-day follow-up period, 50 patients (19.9%) died in the control group compared to 36 (14.1%) in the intervention group resulting in an adjusted odds ratio of 0.57 (95% CI 0.35 to 0.94; p=0.027). Interaction tests did not show significant differences in mortality across the cancer type subgroups. Nutritional support also significantly improved functional outcomes and quality of life measures.

CONCLUSION

Compared to usual hospital nutrition without nutrition support, individualized nutritional support reduced the risk for mortality and improved functional and quality of life outcomes in cancer patients with increased nutritional risk. These data further support the inclusion of nutritional care in cancer management guidelines.

Interest & Impact

Downloads

491 since deposited on 27 May 2021
60 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item