Postoperative arginine-enriched immune modulating nutrition: Long-term survival results from a randomised clinical trial in patients with oesophagogastric and pancreaticobiliary cancer.
Postoperative arginine-enriched immune modulating nutrition: Long-term survival results from a randomised clinical trial in patients with oesophagogastric and pancreaticobiliary cancer.
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DOI：
10.1016/j.clnu.2021.09.040
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Lobo DN
中科院分区：
文献类型：
--
作者：
Adiamah A;Rollins KE;Kapeleris A;Welch NT;Iftikhar SY;Allison SP;Lobo DN
免疫调节营养（IMN）已被证明可以减少胃肠道癌症患者的术后感染并发症和住院时间。在接受头颈癌手术的患者中进行的两项IMN研究也表明，这种治疗可能会改善长期生存率和无进展生存率。在本研究中，我们分析了先前在食管胃和胰胆管癌手术患者中进行的IMN随机对照试验的随访数据，以评估IMN与等热量、等氮对照饲料对术后生存率的长期影响。本研究纳入了接受胰腺癌、食管癌和胃癌手术的患者，这些患者以双盲方式随机接受术后空肠造口术IMN喂养（Stresson，Nutricia Ltd.）或等氮、等热量饲料（Nutrison High Protein，Nutricia）10-15天。主要结局是长期总生存率。对所有108例患者进行了完整随访，每组随机分配54例患者。根据人口统计学[（年龄，p = 0.63）、性别（p = 0.49）或癌症部位（p = 0.25）]，组间无统计学显著差异。30-两组的日死亡率均为11.1%。干预组90天、1年、5年、10年、15年和20年的死亡率分别为13%、31.5%、70.4%、85.2%、88.9%和96.3%。对照组的相应死亡率分别为14.8%、35.2%、68.6%、79.6%、85.2%和98.1%（所有比较p > 0.05）。术后早期给予富含精氨酸的IMN对接受食管胃和胰胆管癌手术的患者的长期生存没有影响。
Immune modulating nutrition (IMN) has been shown to reduce postoperative infectious complications and length of stay in patients with gastrointestinal cancer. Two studies of IMN in patients undergoing surgery for head and neck cancer also suggested that this treatment might improve long-term survival and progression-free survival. In the present study, we analysed follow-up data from our previous randomised controlled trial of IMN, in patients undergoing surgery for oesophagogastric and pancreaticobiliary cancer, in order to evaluate the long-term impact on survival of postoperative IMN versus an isocaloric, isonitrogenous control feed. This study included patients undergoing surgery for cancers of the pancreas, oesophagus and stomach, who had been randomised in a double-blind manner to receive postoperative jejunostomy feeding with IMN (Stresson, Nutricia Ltd.) or an isonitrogenous, isocaloric feed (Nutrison High Protein, Nutricia) for 10–15 days. The primary outcome was long-term overall survival. There was complete follow-up for all 108 patients, with 54 patients randomised to each group. There were no statistically significant differences between groups by demographics [(age, p = 0.63), sex (p = 0.49) or site of cancer (p = 0.25)]. 30-day mortality was 11.1% in both groups. Mortality in the intervention group was 13%, 31.5%, 70.4%, 85.2%, 88.9%, and 96.3% at 90 days, and 1, 5, 10, 15 and 20 years respectively. Corresponding mortality in the control group was 14.8%, 35.2%, 68.6%, 79.6%, 85.2% and 98.1% (p > 0.05 for all comparisons). Early postoperative feeding with arginine-enriched IMN had no impact on long-term survival in patients undergoing surgery for oesophagogastric and pancreaticobiliary cancer.
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影响因子：
6.3
作者：
Lobo, Dileep N.;Williams, Robert N.;Rowlands, Brian J.
通讯作者：
Rowlands, Brian J.
影响因子：
7.1
作者：
Boisselier, Pierre;Kaminsky, Marie-Christine;Senesse, Pierre
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Senesse, Pierre
影响因子：
2.9
作者：
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Zalcberg, John R.
影响因子：
120.7
作者：
Heyland, DK;Novak, F;Suchner, U
通讯作者：
Suchner, U
影响因子：
7.1
作者：
Buijs, Nikki;van Bokhorst de van der Schueren, Marian A. E.;van Leeuwen, Paul A. M.
通讯作者：
van Leeuwen, Paul A. M.