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Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a prospective, randomized clinical trial.
Nutr Hosp 2008 Mar-Apr; 23(2):105-10NH

Abstract

INTRODUCTION

Significant malnutrition exists in a high percentage of patients with head and neck cancer. Malnutrition is associated with defects in immune function that may impair the host response to malignancy. Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications.

OBJECTIVES

Compare two immunoenhanced enteral nutritions with a control diet, and evaluate the effect in postoperative infections, length of stay and inflammatory markers.

PATIENTS

A population of 44 patients with oral and laryngeal cancer was enrolled in a randomized trial. At surgery, patients were randomly allocated to three groups: (group I); patients receiving an arginine-enhanced formula (group II); patients receiving a standard polymeric formula, and (group III) patients receiving an arginine, RNA and omega-3 fatty acids enhanced formula, in an isonitrogenous way.

RESULTS

The duration of enteral nutrition in the three groups was similar with an average duration of 14,5 +/- 8 days. The length of postoperative stay was similar, with an average of 19,8 +/- 8,5 days. Wound infections and general infections were more frequent in the control group. Fistula rates were not improved in the enhanced diet groups. No significant intergroup differences in the trend of the two plasma proteins (albumin, transferrin), lymphocytes, weight, IL-6, CPR and TNFalpha were detected. The control group showed the highest levels of TNFalpha at the fourteenth postoperative day. Gastrointestinal tolerance and diarrhoea rate were similar in all the patients.

CONCLUSIONS

Immunoenhanced enteral nutrition formulas improved the infection rate in the postoperative of head and neck cancer patients. In the fistula rates, we observed that technical problems and nutritional status might have played an equally important role, and therefore the positive effect of immunonutrition in this parameter might have been overestimated.

Authors+Show Affiliations

Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain. pablocasas@clinicasas.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18449445

Citation

Casas-Rodera, P, et al. "Immunoenhanced Enteral Nutrition Formulas in Head and Neck Cancer Surgery: a Prospective, Randomized Clinical Trial." Nutricion Hospitalaria, vol. 23, no. 2, 2008, pp. 105-10.
Casas-Rodera P, Gómez-Candela C, Benítez S, et al. Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a prospective, randomized clinical trial. Nutr Hosp. 2008;23(2):105-10.
Casas-Rodera, P., Gómez-Candela, C., Benítez, S., Mateo, R., Armero, M., Castillo, R., & Culebras, J. M. (2008). Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a prospective, randomized clinical trial. Nutricion Hospitalaria, 23(2), pp. 105-10.
Casas-Rodera P, et al. Immunoenhanced Enteral Nutrition Formulas in Head and Neck Cancer Surgery: a Prospective, Randomized Clinical Trial. Nutr Hosp. 2008;23(2):105-10. PubMed PMID: 18449445.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a prospective, randomized clinical trial. AU - Casas-Rodera,P, AU - Gómez-Candela,C, AU - Benítez,S, AU - Mateo,R, AU - Armero,M, AU - Castillo,R, AU - Culebras,J M, PY - 2007/04/10/received PY - 2007/06/13/accepted PY - 2008/5/2/pubmed PY - 2008/8/30/medline PY - 2008/5/2/entrez SP - 105 EP - 10 JF - Nutricion hospitalaria JO - Nutr Hosp VL - 23 IS - 2 N2 - INTRODUCTION: Significant malnutrition exists in a high percentage of patients with head and neck cancer. Malnutrition is associated with defects in immune function that may impair the host response to malignancy. Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications. OBJECTIVES: Compare two immunoenhanced enteral nutritions with a control diet, and evaluate the effect in postoperative infections, length of stay and inflammatory markers. PATIENTS: A population of 44 patients with oral and laryngeal cancer was enrolled in a randomized trial. At surgery, patients were randomly allocated to three groups: (group I); patients receiving an arginine-enhanced formula (group II); patients receiving a standard polymeric formula, and (group III) patients receiving an arginine, RNA and omega-3 fatty acids enhanced formula, in an isonitrogenous way. RESULTS: The duration of enteral nutrition in the three groups was similar with an average duration of 14,5 +/- 8 days. The length of postoperative stay was similar, with an average of 19,8 +/- 8,5 days. Wound infections and general infections were more frequent in the control group. Fistula rates were not improved in the enhanced diet groups. No significant intergroup differences in the trend of the two plasma proteins (albumin, transferrin), lymphocytes, weight, IL-6, CPR and TNFalpha were detected. The control group showed the highest levels of TNFalpha at the fourteenth postoperative day. Gastrointestinal tolerance and diarrhoea rate were similar in all the patients. CONCLUSIONS: Immunoenhanced enteral nutrition formulas improved the infection rate in the postoperative of head and neck cancer patients. In the fistula rates, we observed that technical problems and nutritional status might have played an equally important role, and therefore the positive effect of immunonutrition in this parameter might have been overestimated. SN - 0212-1611 UR - https://www.unboundmedicine.com/medline/citation/18449445/Immunoenhanced_enteral_nutrition_formulas_in_head_and_neck_cancer_surgery:_a_prospective_randomized_clinical_trial_ L2 - https://medlineplus.gov/headandneckcancer.html DB - PRIME DP - Unbound Medicine ER -