Skip to main content

Advertisement

SpringerLink
Log in

Surgery in Esophageal and Gastric Cancer Patients: What is the Role for Nutrition Support in your Daily Practice?

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Cancers of the esophagus and stomach have a major impact on patients’ nutritional status by virtue of these organs’ inherent digestive functions. Many patients with these cancers will require surgical intervention, which imposes further metabolic demands and compounds preexisting nutritional disorders. Patients with esophagogastric cancer are likely to have lost weight by the time the diagnosis is made. This fact alone is of clinical importance, because it is well known that patients who have lost weight will have higher operative mortality and morbidity rates than patients who maintain their weight. Initial assessment of patients with esophagogastric cancer should include a routine evaluation of nutritional status. This will allow the identification of patients who are at risk of complications, particularly in the postoperative setting. These patients should be targeted for specific nutritional support.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Mariette C, Piessen G, Briez N, Gronnier C, Triboulet JP. Oesophagogastric junction adenocarcinoma: which therapeutic approach? Lancet Oncol. 2011;12:296–305.

    Article  PubMed  Google Scholar 

  2. Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs. 2005;9(Suppl 2):S51–63.

    Article  PubMed  Google Scholar 

  3. DeWys W. Management of cancer cachexia. Semin Oncol. 1985;12:452–60.

    PubMed  CAS  Google Scholar 

  4. Dewys WD, Begg C, Lavin PT, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69:491–7.

    Article  PubMed  CAS  Google Scholar 

  5. Gupta R, Ihmaidat H. Nutritional effects of oesophageal, gastric and pancreatic carcinoma. Eur J Surg Oncol. 2003;29:634–43.

    Article  PubMed  CAS  Google Scholar 

  6. Moore FA. Effects of immune-enhancing diets on infectious morbidity and multiple organ failure. JPEN J Parenter Enteral Nutr. 2001;25(Suppl 2):S36–42; discussion S42–3.

    Google Scholar 

  7. Bozzetti F, Braga M, Gianotti L, et al. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial. Lancet. 2001;358:1487–92.

    Article  PubMed  CAS  Google Scholar 

  8. Senesse P, Assenat E, Schneider S, Chargari C, Magné N, Azria D, Hébuterne X. Nutritional support during oncologic treatment of patients with gastrointestinal cancer: who could benefit? Cancer Treat Rev. 2008;34:568–75.

    Article  PubMed  Google Scholar 

  9. Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition. 1996;12(Suppl 1):S15–9.

    PubMed  CAS  Google Scholar 

  10. Pajak TF, Laramore GE, Marcial VA, et al. Elapsed treatment days–a critical item for radiotherapy quality control review in head and neck trials: RTOG report. Int J Radiat Oncol Biol Phys. 1991;20:13–20.

    Article  PubMed  CAS  Google Scholar 

  11. Stratton RJ, Elia M. Deprivation linked to malnutrition risk and mortality in hospital. Br J Nutr. 2006;96:870–6.

    Article  PubMed  CAS  Google Scholar 

  12. Meyer L, Meyer F, Dralle H, et al. Insufficiency risk of esophagojejunal anastomosis after total abdominal gastrectomy for gastric carcinoma. Langenbecks Arch Surg. 2005;390:510–6.

    Article  PubMed  CAS  Google Scholar 

  13. Andreyev HJ, Norman AR, Oates J, Cunningham D. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1998;34:503–9.

    Article  PubMed  CAS  Google Scholar 

  14. Kelsen DP, Ginsberg R, Pajak TF, et al. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med. 1998;339:1979–84.

    Article  PubMed  CAS  Google Scholar 

  15. Mariette C, Alves A, Benoist S, et al. Perioperative care in digestive surgery. J Chir (Paris). 2005;142:14–28.

    CAS  Google Scholar 

  16. Weimann A, Braga M, Harsanyi L, et al. ESPEN Guidelines on Enteral Nutrition: surgery including organ transplantation. Clin Nutr. 2006;25:224–44.

    Article  PubMed  CAS  Google Scholar 

  17. Arends J, Bodoky G, Bozzetti F, et al. ESPEN Guidelines on Enteral Nutrition: non-surgical oncology. Clin Nutr. 2006;25:245–59.

    Article  PubMed  CAS  Google Scholar 

  18. Conference de consensus. Nutrition périopératoire en chirurgie réglée de l’adulte. Nutr Clin Metabol. 1995;9(Suppl 1):1–150.

    Google Scholar 

  19. Brown RE, Abbas AE, Ellis S, et al. A prospective phase II evaluation of esophageal stenting for neoadjuvant therapy for esophageal cancer: optimal performance and surgical safety. J Am Coll Surg. 2011;212:582–8.

    Article  PubMed  Google Scholar 

  20. Pellen MG, Sabri S, Razack A, Gilani SQ, Jain PK. Safety and efficacy of self-expanding removable metal esophageal stents during neoadjuvant chemotherapy for resectable esophageal cancer. Dis Esophagus. 2011 May 19. [Epub ahead of print].

  21. Maruthachalam K, Lash GE, Shenton BK, Horgan AF. Tumour cell dissemination following endoscopic stent insertion. Br J Surg. 2007;94:1151–4.

    Article  PubMed  CAS  Google Scholar 

  22. Lipman TO. Grains or veins: is enteral nutrition really better than parenteral nutrition? A look at the evidence. JPEN J Parenter Enteral Nutr. 1998;22:167–82.

    Article  PubMed  CAS  Google Scholar 

  23. Mazaki T, Ebisawa K. Enteral versus parenteral nutrition after gastrointestinal surgery: a systematic review and meta-analysis of randomized controlled trials in the English literature. J Gastrointest Surg. 2008;12:739–55.

    Article  PubMed  Google Scholar 

  24. Braunschweig CL, Levy P, Sheean PM, Wang X. Enteral compared with parenteral nutrition: a meta-analysis. Am J Clin Nutr. 2001;74:534–42.

    PubMed  CAS  Google Scholar 

  25. Margolis M, Alexander P, Trachiotis GD, Gharagozloo F, Lipman T. Percutaneous endoscopic gastrostomy before multimodality therapy in patients with esophageal cancer. Ann Thorac Surg. 2003;76:1694–7.

    Article  PubMed  Google Scholar 

  26. Stockeld D, Fagerberg J, Granström L, Backman L. Percutaneous endoscopic gastrostomy for nutrition in patients with oesophageal cancer. Eur J Surg. 2001;167:839–44.

    Article  PubMed  CAS  Google Scholar 

  27. Mariette C, Piessen G, Briez N, Triboulet JP. The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent. Ann Surg. 2008;247:365–71.

    Article  PubMed  Google Scholar 

  28. Tessier W, Piessen G, Briez N, Boschetto A, Ernst O, Mariette C. Feasibility and safety of percutaneaous radiological gastrostomy during multimodality therapy in patients with oesophageal cancer. Am J Surg. (in press).

  29. Howard L, Ashley C. Nutrition in the perioperative patient. Annu Rev Nutr. 2003;23:263–82.

    Article  PubMed  CAS  Google Scholar 

  30. Heyland DK, Montalvo M, MacDonald S, et al. Total parenteral nutrition in the surgical patient: a meta-analysis. Can J Surg. 2001;44:102–11.

    PubMed  CAS  Google Scholar 

  31. Beale RJ, Bryg DJ, Bihari DJ. Immunonutrition in the critically ill: a systematic review of clinical outcome. Crit Care Med. 1999;27:2799–805.

    Article  PubMed  CAS  Google Scholar 

  32. Heyland DK, Novak F, Drover JW, et al. Should immunonutrition become routine in critically ill patients? A systematic review of the evidence. JAMA. 2001;286:944–53.

    Article  PubMed  CAS  Google Scholar 

  33. Heys SD, Walker LG, Smith I, Eremin O. Enteral nutritional supplementation with key nutrients in patients with critical illness and cancer: a metaanalysis of randomized controlled clinical trials. Ann Surg. 1999;229:467–77.

    Article  PubMed  CAS  Google Scholar 

  34. Gianotti L, Braga M, Nespoli L, et al. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology. 2002;122:1763–70.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Digestive and Oncological Surgery, University Hospital C. Huriez, Centre Hospitalier Régional Universitaire, Lille, Cedex, France

    Christophe Mariette MD, PhD, Marie-Laure De Botton ANP & Guillaume Piessen MD, PhD

  2. University of Lille - Nord de France, Lille, Cedex, France

    Christophe Mariette MD, PhD & Guillaume Piessen MD, PhD

  3. Inserm, UMR837, Team 5 “Mucins, epithelial differentiation and carcinogenesis”, JPARC, Lille, Cedex, France

    Christophe Mariette MD, PhD & Guillaume Piessen MD, PhD

Authors
  1. Christophe Mariette MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marie-Laure De Botton ANP
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guillaume Piessen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christophe Mariette MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mariette, C., De Botton, ML. & Piessen, G. Surgery in Esophageal and Gastric Cancer Patients: What is the Role for Nutrition Support in your Daily Practice?. Ann Surg Oncol 19, 2128–2134 (2012). https://doi.org/10.1245/s10434-012-2225-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-012-2225-6

Keywords

Search

Navigation