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

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Aujesky, Drahomir; Rodondi, Nicolas; Donzé, Jacques and Stanga, Zeno

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1569-8041

Publisher:

Elsevier

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

27 May 2021 19:58

Last Modified:

19 Jul 2021 01:33

Publisher DOI:

10.1016/j.annonc.2021.05.793

PubMed ID:

34022376

Uncontrolled Keywords:

cancer malnutrition nutrition outcomes randomized trial

BORIS DOI:

10.48350/156526

URI:

https://boris.unibe.ch/id/eprint/156526

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