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Supportive Care in Cancer

, Volume 25, Issue 11, pp 3587–3593 | Cite as

Long-term follow-up of the potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial

  • Kate FurnessEmail author
  • Mary Anne Silvers
  • June Savva
  • Catherine E. Huggins
  • Helen Truby
  • Terry Haines
Original Article

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

Early and intensive nutrition intervention may increase the survival of people with upper gastrointestinal cancer.

Keywords

Survival analysis Dietetics Oesophageal cancer Stomach cancer 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Nutrition and Dietetics, Monash HealthMonash Medical CentreClaytonAustralia
  2. 2.Nutrition and Dietetics, Monash HealthClaytonAustralia
  3. 3.Nutrition and Dietetics, Monash HealthMoorabbinAustralia
  4. 4.Department of Nutrition Dietetics and FoodMonash UniversityNotting HillAustralia
  5. 5.Allied Health Research Unit, Monash HealthMonash Medical CentreClaytonAustralia

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