Effects of enteral nutrition and parenteral nutrition on survival in patients with advanced cancer cachexia: Analysis of a multicenter prospective cohort study

Amano, Koji; Maeda, Isseki; Ishiki, Hiroto; Miura, Tomofumi; Hatano, Yutaka; Tsukuura, Hiroaki; Taniyama, Tomohiko; Matsumoto, Yoshihisa; Matsuda, Yosuke; Kohara, Hiroyuki; Morita, Tatsuya; Mori, Masanori; Inoue, Satoshi; Yokomichi, Naosuke; Imai, Kyoichi; Yamauchi, Toshihiro; Naito, Akemi Shirado; Uneno, Yu; Yoshioka, Akira; Hiramoto, Shuji; Kikuchi, Ayako; Hori, Tomohide; Funaki, Hiromi; Tanaka, Keiko; Suzuki, Kozue; Kamei, Tina; Azuma, Yoko; Uno, Teruaki; Miyamoto, Jiro; Katayama, Hirofumi; Kashiwagi, Hideyuki; Matsumoto, Eri; Oya, Kiyofumi; Yamaguchi, Takeya; Okamura, Tomonao; Hashimoto, Hoshu; Kosugi, Shunsuke; Ikuta, Nao; Matsumoto, Yaichiro; Ohmori, Takashi; Nakai, Takehiro; Ikee, Takashi; Unoki, Yuto; Kitade, Kazuki; Koito, Shu; Ishibashi, Nanao; Ehara, Masaya; Kuwahara, Kosuke; Ueno, Shohei; Nakashima, Shinji; Ishiyama, Yuta; Sakashita, Akihiro; Matsunuma, Ryo; Takatsu, Hana; Yamaguchi, Takashi; Ito, Satoko; Terabayashi, Toru; Nakagawa, Jun; Yamagiwa, Tetsuya; Inoue, Akira; Yamaguchi, Takuhiro; Miyashita, Mitsunori; Yoshida, Saran; Hiratsuka, Yusuke; Tagami, Keita; Watanabe, Hiroaki; Odagiri, Takuya; Ito, Tetsuya; Ikenaga, Masakazu; Shimizu, Katsuji; Hayakawa, Akira; Kamura, Rena; Okoshi, Takeru; Nishi, Tomohiro; Kosugi, Kazuhiro; Shibata, Yasuhiro; Hisanaga, Takayuki; Higashibata, Takahiro; Yabuki, Ritsuko; Hagiwara, Shingo; Shimokawa, Miho; Miyaké, Satoshi; Nozato, Junko; Iriyama, Tetsuji; Kaneishi, Keisuke; Baba, Mika; Okizaki, Ayumi; Watanabe, Yuki; Uehara, Yuko; Satomi, Eriko; Nishijima, Kaoru; Shimoinaba, Junichi; Nakahori, Ryoichi; Hirohashi, Takeshi; Hamano, Jun; Kawashima, Natsuki; Kawaguchi, Takashi; Uchida, Megumi; Sato, Ko; Matsuda, Yoichi; Tsuneto, Satoru; Maeda, Sayaka; Kizawa, Yoshiyuki; Otani, Hiroyuki

doi:10.1016/j.clnu.2020.07.027

Cited by 39 publications

(32 citation statements)

References 30 publications

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“…Many studies have shown that intestinal nutrition improves immunocompetence more than intravenous nutrition [92]. In both pre-cachexia and cachexia, if oral intake is possible, nutrient requirements should be supplemented orally as much as possible, for example, with oral nutritional support (ONS) [32,93]. The ESMO guidelines also recommend ONS [26].…”

Section: Energy Metabolism and Nutritional Support In Cancer Cachexiamentioning

confidence: 99%

Cancer Cachexia: Its Mechanism and Clinical Significance

Nishikawa

Goto

Fukunishi

et al. 2021

IJMS

101

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The term “cachexia” is derived from the Greek words kakos (bad) and hexis (habit). Cachexia is a malnutrition associated with chronic diseases such as cancer, chronic heart failure, chronic renal failure, and autoimmune diseases, and is characterized by decreased skeletal muscle mass. Cancer cachexia is quite common in patients with advanced cancer. Weight loss is also a characteristic symptom of cancer cachexia, along with decreased skeletal muscle mass. As nutritional supplementation alone cannot improve cachexia, cytokines and tumor-derived substances have been attracting attention as its relevant factors. Cancer cachexia can be also associated with reduced chemotherapeutic effects, increased side effects and treatment interruptions, and even poorer survival. In 2011, a consensus definition of cachexia has been proposed, and the number of relevant research reports has increased significantly. However, the pathogenesis of cachexia is not fully understood, and there are currently few regulatory-approved standard treatments for cachexia. The main reason for this is that multiple etiologies are involved in the development of cachexia. In this review, we will outline the current status of cachexia, the mechanisms of which have been elucidated in recent years, especially from the perspective of advanced cancer.

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Section: Energy Metabolism and Nutritional Support In Cancer Cachexiamentioning

confidence: 99%

Cancer Cachexia: Its Mechanism and Clinical Significance

Nishikawa

Goto

Fukunishi

et al. 2021

IJMS

101

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show abstract

“…Since this systematic review was published, further studies on parenteral nutrition in advanced cancer have been reported [49,50]. Thus, Bouleuc et al (2020) reported a randomised controlled trial of parenteral nutrition versus oral feeding in patients with advanced cancer and malnutrition (and a functioning gastrointestinal tract) [49]: in this cohort of patients, parenteral nutrition was not associated with improved health related quality of life, or survival, but was associated with more adverse effects.…”

Section: Any Decision To Initiate Clinically Assisted Nutritionmentioning

confidence: 94%

“…(2020) reported a secondary analysis of a prospective observational study of end-of-life care in palliative care units in Japan [50]: in this cohort of patients, enteral and parenteral nutrition was associated with increased survival as compared to oral feeding. 4.…”

Section: Any Decision To Initiate Clinically Assisted Nutritionmentioning

confidence: 99%

Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/guidance on the use of clinically assisted nutrition in patients with advanced cancer

Alderman

Allan

Amano

et al. 2021

Support Care Cancer

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Purpose The pro vision of clinically assisted nutrition (CAN) in patients with advanced cancer is controversial, and there is a paucity of specific guidance, and so a diversity in clinical practice. Consequently, the Palliative Care Study Group of the Multinational Association of Supportive Care in Cancer (MASCC) formed a Subgroup to develop evidence-based guidance on the use CAN in patients with advanced cancer. Methods This guidance was developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews/trials respectively. The outcomes of the review were categorised by the level of evidence, and a “category of guideline” based on the level of evidence (i.e. “recommendation”, “suggestion”, or “no guideline possible”). Results The Subgroup produced 11 suggestions, and 1 recommendation (due to the paucity of evidence). These outcomes relate to assessment of patients, indications for CAN, contraindications for CAN, procedures for initiating CAN, and re-assessment of patients. Conclusions This guidance provides a framework for the use of CAN in advanced cancer, although every patient needs individualised management.

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“…artificially administered nutrition and hydration PNH parenteral nutrition and hydration ETF enteral tube feeding QOL quality of life 5 weeks who were admitted to palliative care units demonstrated the potentially beneficial effects of AANH on survival [5].…”

Section: Aanhmentioning

confidence: 99%

The prevalence of artificially administered nutrition and hydration in different age groups among patients with advanced cancer admitted to palliative care units

Amano

Satomi²,

Oyamada

et al. 2021

Clinical Nutrition Open Science

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Background & Aims: The prevalence of artificially administered nutrition and hydration (AANH) in different age groups among patients with advanced cancer remains unknown. The present study investigated the current utilization of AANH according to age groups in palliative care units. Methods: This was a secondary analysis of a prospective cohort study. We obtained information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate or total calorie intake on the 7th day of admission. Patients were divided into five age groups ( 18e39, 40e59, 60e74, 75e89, and 90-years). Among patients receiving AANH, the proportions of higher-calorie AANH were compared between the five age groups. Results: A total of 1453 patients were included. The proportion of patients categorized as receiving nutrition and hydration via the parenteral route was the highest in the 18e39 and 40e59 groups (52.4 and 41.1%, respectively). Among patients receiving AANH (n ¼ 534), the proportions of patients categorized into the <25% or <250 kcal/day group were 57.9% in all groups, 18.2% in the 18e39 group, and 50.0e66.4% in the other groups. The proportions of 50% or 500 kcal/day and 25% or 250 kcal/day in each age group significantly decreased with age (p ¼ 0.003 and 0.002, respectively). Conclusion:The present results revealed large variations in the use of AANH in different age groups and indicate that AANH was more frequently utilized in younger age groups in palliative care units.

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Effects of enteral nutrition and parenteral nutrition on survival in patients with advanced cancer cachexia: Analysis of a multicenter prospective cohort study

Cited by 39 publications

References 30 publications

Cancer Cachexia: Its Mechanism and Clinical Significance

Cancer Cachexia: Its Mechanism and Clinical Significance

Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/guidance on the use of clinically assisted nutrition in patients with advanced cancer

The prevalence of artificially administered nutrition and hydration in different age groups among patients with advanced cancer admitted to palliative care units

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