ROLE OF PARENTERAL NUTRITION IN ONCOLOGIC PATIENTS WITH INTESTINAL OCCLUSION AND PERITONEAL CARCINOMATOSIS

Area of Science:

• Oncology
• Gastroenterology
• Clinical Nutrition

Background:

• The role of parenteral nutrition (PN) in advanced cancer patients with intestinal occlusion remains unclear.
• This study investigates the prognostic impact of PN in this patient population.

Purpose of the Study:

• To determine the effect of parenteral nutrition on the prognosis of oncologic patients experiencing intestinal occlusion.
• To assess the safety and efficacy of PN in managing complex cancer-related gastrointestinal issues.

Main Methods:

• A cohort of 55 patients with intestinal occlusion and peritoneal carcinomatosis received PN (20-35 kcal/Kg/day, 1.0 g/kg/day amino acids).
• Data collected included tumor type, chemotherapy history, Eastern Cooperative Oncology Group (ECOG) performance status, body mass index (BMI), and survival outcomes.
• Statistical analysis used log-rank tests to compare survival based on various baseline characteristics and treatment strategies.

Main Results:

• The majority of patients (69.1%) had gastrointestinal tumors; 85% presented with malnutrition.
• PN initiation did not significantly impact survival based on ECOG, prior chemotherapy, baseline BMI, or tumor type.
• Survival was significantly higher in patients receiving home PN post-discharge (p=0.008) and those receiving chemotherapy concurrently with or after PN (p<0.001).
• Catheter-related infections occurred in 3.6% of patients but did not affect survival (p=0.804).

Conclusions:

• Parenteral nutrition is a safe supportive therapy for advanced cancer patients with intestinal obstruction.
• For patients responding to chemotherapy, home PN administration alongside continued chemotherapy may lead to prolonged survival.
• Optimizing PN delivery, particularly at home, alongside active cancer treatment, shows promise for improved outcomes.