Long-term follow-up of the potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial
- 450 Downloads
This study aimed to evaluate the long-term survival of all patients who participated in a pilot randomised trial of an early nutritional intervention for adults with upper gastrointestinal cancer. It also sought to identify factors that predicted patient mortality.
All participants (n = 21) who were randomised into the original study were followed for a maximum of 5 years and 2 months (final follow-up April 2016). The primary outcome measure was time from date of recruitment until date of death, ascertained by the Victorian Cancer Registry and/or Monash Health Scanned Medical Records. Secondary analyses were conducted to identify factors that adversely affected survival.
At the end of the follow-up period, three patients were alive in the nutrition intervention group whilst only two patients were living from the standard care group. Visual evaluation of the Kaplan-Meier survival curves demonstrated a possible survival benefit from being exposed to the intervention between 6 months and 1.4 years post-recruitment, though this benefit dissipated soon after. The intervention was not associated with increased survival in univariate analyses, but was after adjustment for other factors found to adversely impact on survival (adjusted hazard ratio 0.12 (95% CI 0.02–0.72) p = 0.02). These factors were being a smoker (14.2 (1.43 to 140.67), p = 0.02); low baseline physical functioning (1.11 (1.01 to 1.21), p = 0.03); high baseline fatigue (1.09 (1.02–1.16), p = 0.007); and high baseline dyspnoea (1.08 (1.02–1.13), p = 0.003).
Early and intensive nutrition intervention may increase the survival of people with upper gastrointestinal cancer.
KeywordsSurvival analysis Dietetics Oesophageal cancer Stomach cancer
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Australian Institute of Health and Welfare (2012) Cancer survival and prevalence in Australia: period estimates from 1982 to 2010. Cancer series no. 69. Cat. no. CAN 65. Canberra, AIHWGoogle Scholar
- 4.Di Fiore F, Lecleire S, Pop D, Rigal O, Hamidou H, Paillot B, Ducrotte P, Lerebours E, Michel P (2007) Baseline nutritional status is predictive of response to treatment and survival in patients treated by definitive chemoradiotherapy for a locally advanced esophageal cancer. Am J Gastroenterol 102:2557–2563CrossRefGoogle Scholar
- 6.Healy LA, Ryan AM, Moore J, Rowley S, Ravi N, Byrne PJ, Reynolds JV (2008) Health-related quality of life assessment at presentation may predict complications and early relapse in patients with localized cancer of the esophagus. Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus 21:522–528CrossRefGoogle Scholar
- 14.Roussel LM, Micault E, Peyronnet D, Blanchard D, Guarnieri S, Choussy O, Gery B, Bequignon A, Joubert C, Parienti JJ, Babin E (2017) Intensive nutritional care for patients treated with radiotherapy in head and neck cancer: a randomized study and meta-analysis. European Archives of Oto-rhino-laryngology: Official Journal of the European Federation of Oto-rhino-laryngological Societies 274:977–987CrossRefGoogle Scholar
- 15.Silvers MA, Savva J, Huggins CE, Truby H, Haines T (2014) Potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer 22:3035–3044CrossRefGoogle Scholar