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Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival.
Am J Clin Nutr. 2010 Nov; 92(5):1151-6.AJ

Abstract

BACKGROUND

Plasma arginine concentrations are lower in patients with cancer, which indicates that arginine metabolism may be disturbed in these patients. Arginine supplementation has been associated with positive effects on antitumor mechanisms and has been shown to reduce tumor growth and to prolong survival. Furthermore, the prognosis of patients with head and neck cancer remains disappointing. Insufficient intake frequently leads to malnutrition, which contributes to high morbidity and mortality rates.

OBJECTIVE

The aim of this study was to assess the long-term effects of perioperative arginine supplementation in severely malnourished patients with head and neck cancer.

DESIGN

In this double-blind, randomized, controlled trial, we randomly assigned 32 severely malnourished patients with head and neck cancer to receive 1) standard perioperative enteral nutrition (n = 15) or 2) arginine-supplemented perioperative enteral nutrition (n = 17). The primary outcome was long-term (≥10 y) survival. Secondary outcomes included the long-term appearance of locoregional recurrence, distant metastases, and second primary tumors.

RESULTS

No significant differences in baseline characteristics were observed between groups. The group receiving arginine-enriched nutrition had a significantly better overall survival (P = 0.019) and better disease-specific survival (P = 0.022). Furthermore, the arginine-supplemented group had a significantly better locoregional recurrence-free survival (P = 0.027). No significant difference in the occurrence of distant metastases or occurrence of a second primary tumor was observed between the groups.

CONCLUSION

Perioperative arginine-enriched enteral nutrition significantly improved the long-term overall survival and long-term disease-specific survival in malnourished patients with head and neck cancer.

Authors+Show Affiliations

Department of Surgery, VU University Medical Center, MB Amsterdam, Netherlands.No 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20881073

Citation

Buijs, Nikki, et al. "Perioperative Arginine-supplemented Nutrition in Malnourished Patients With Head and Neck Cancer Improves Long-term Survival." The American Journal of Clinical Nutrition, vol. 92, no. 5, 2010, pp. 1151-6.
Buijs N, van Bokhorst-de van der Schueren MA, Langius JA, et al. Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival. Am J Clin Nutr. 2010;92(5):1151-6.
Buijs, N., van Bokhorst-de van der Schueren, M. A., Langius, J. A., Leemans, C. R., Kuik, D. J., Vermeulen, M. A., & van Leeuwen, P. A. (2010). Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival. The American Journal of Clinical Nutrition, 92(5), 1151-6. https://doi.org/10.3945/ajcn.2010.29532
Buijs N, et al. Perioperative Arginine-supplemented Nutrition in Malnourished Patients With Head and Neck Cancer Improves Long-term Survival. Am J Clin Nutr. 2010;92(5):1151-6. PubMed PMID: 20881073.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival. AU - Buijs,Nikki, AU - van Bokhorst-de van der Schueren,Marian A E, AU - Langius,Jacqueline A E, AU - Leemans,C Rene, AU - Kuik,Dirk J, AU - Vermeulen,Mechteld A R, AU - van Leeuwen,Paul A M, Y1 - 2010/09/29/ PY - 2010/10/1/entrez PY - 2010/10/1/pubmed PY - 2010/11/10/medline SP - 1151 EP - 6 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 92 IS - 5 N2 - BACKGROUND: Plasma arginine concentrations are lower in patients with cancer, which indicates that arginine metabolism may be disturbed in these patients. Arginine supplementation has been associated with positive effects on antitumor mechanisms and has been shown to reduce tumor growth and to prolong survival. Furthermore, the prognosis of patients with head and neck cancer remains disappointing. Insufficient intake frequently leads to malnutrition, which contributes to high morbidity and mortality rates. OBJECTIVE: The aim of this study was to assess the long-term effects of perioperative arginine supplementation in severely malnourished patients with head and neck cancer. DESIGN: In this double-blind, randomized, controlled trial, we randomly assigned 32 severely malnourished patients with head and neck cancer to receive 1) standard perioperative enteral nutrition (n = 15) or 2) arginine-supplemented perioperative enteral nutrition (n = 17). The primary outcome was long-term (≥10 y) survival. Secondary outcomes included the long-term appearance of locoregional recurrence, distant metastases, and second primary tumors. RESULTS: No significant differences in baseline characteristics were observed between groups. The group receiving arginine-enriched nutrition had a significantly better overall survival (P = 0.019) and better disease-specific survival (P = 0.022). Furthermore, the arginine-supplemented group had a significantly better locoregional recurrence-free survival (P = 0.027). No significant difference in the occurrence of distant metastases or occurrence of a second primary tumor was observed between the groups. CONCLUSION: Perioperative arginine-enriched enteral nutrition significantly improved the long-term overall survival and long-term disease-specific survival in malnourished patients with head and neck cancer. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/20881073/Perioperative_arginine_supplemented_nutrition_in_malnourished_patients_with_head_and_neck_cancer_improves_long_term_survival_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2010.29532 DB - PRIME DP - Unbound Medicine ER -