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Nutritional Status and Interventions for Patients with Cancer

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (5 November 2023) | Viewed by 32782

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Special Issue Editors

Dr. Nuno Borges

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FCNAUP, Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal
Interests: amino acids; nutritional biomarkers; metabolic control; phenylketonuria; phenylalanine; glycomacropeptide; acceptability
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Fernando Mendes

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1. H&TRC—Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal
2. Biophysics Institute of Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, 3000-548 Coimbra, Portugal
3. Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3000-548 Coimbra, Portugal
4. European Association for Professions in Biomedical Sciences, 1000 Brussels, Belgium
Interests: lung cancer; inflammation; radiation effects; immune oncology; biomarkers
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Dr. Diana Martins

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Politécnico de Coimbra, ESTeSC, UCPCBL, Rua 5 de Outubro-SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
Interests: cancer; immunotherapy; biomarkers; tumors; treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cancer is one of the leading causes of morbidity and mortality worldwide. The World Cancer Research Fund determined that the diet and nutrition conditions of the individuals are modifiable risk factors in the development of several cancers and a predominant component in the recovery and effectiveness of the treatments. Nutritional intervention is critical, but nutritional support is not widely accessible to all, so nutritional risk and nutrition wasting. A multidisciplinary approach with targeted nutrition is vital to improve the quality of care in oncology. Cachexia management remains a challenge in clinical practice and malnutrition is accepted as a significant negative predictive and prognostic factor in all cancer patients. The importance of metabolic interactions within the tumours are crucial and the mechanisms by which dietary factors might increase or decrease therapeutic intervention are key factors to unravel the nutrition influences in cellular and molecular processes in cancer.

This Special Issue is committed to publishing original research articles on cancer nutrition-related intervention, diagnosis, and prevention. We aim to provide a comprehensive update on nutrition scientific evidence as a crucial factor in preventing, promoting, and treating cancer scenarios. Review articles on these topics are welcome.

Prof. Dr. Nuno Borges
Prof. Dr. Fernando Mendes
Prof. Dr. Diana Martins
Guest Editors

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Keywords

cancer
diet
nutrition
tumors
malnutrition
clinical nutrition
dietary factors

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Published Papers (12 papers)

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11 pages, 570 KiB

Open AccessArticle

Pretreatment Modified Glasgow Prognostic Score for Predicting Prognosis and Survival in Elderly Patients with Gastric Cancer Treated with Perioperative FLOT

by Ebru Melekoglu, Ertugrul Bayram, Saban Secmeler, Burak Mete and Berksoy Sahin

Nutrients 2023, 15(19), 4156; https://doi.org/10.3390/nu15194156 - 26 Sep 2023

Cited by 4 | Viewed by 1571

Abstract

The adverse effects of chemotherapy are more apparent in elderly patients and lead to worse prognosis and mortality. Identifying immunonutritional risk factors is of great importance in terms of treatment effectiveness, prognosis, and mortality in geriatric oncology. The modified Glasgow prognostic score (mGPS) is an immunonutritional index based on serum CRP and albumin levels. In this study, we aimed to investigate the role of mGPS in predicting prognosis and survival in elderly patients with gastric cancer receiving perioperative FLOT treatment. We retrospectively enrolled 71 patients aged over 65 years and grouped them according to their pretreatment mGPS score. Kaplan-Meier and Cox regression analysis showed overall survival was significantly worse in the mGPS 1 and mGPS 2 groups than in the mGPS 0 group (p = 0.005 and p < 0.001, respectively). Compared to the mGPS 0 group, the mGPS 1 group had a 6.25 times greater risk of death (95% CI: 1.61–24.28, p = 0.008), and the mGPS 2 group had a 6.59 times greater risk of death (95% CI: 2.08–20.85, p = 0.001). High BMI was identified as a significant risk factor for being in the mGPS 2 group (OR: 1.20, 95% CI: 1.018–1.425, p = 0.030). In conclusion, elevated pretreatment mGPS was associated with poor overall survival in elderly patients with gastric cancer treated with perioperative FLOT therapy. As such, pretreatment mGPS can be a simple and useful tool to predict mortality in this specific patient group. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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12 pages, 1264 KiB

Open AccessArticle

Identification of ¹⁸F-FDG PET/CT Parameters Associated with Weight Loss in Patients with Esophageal Cancer

by Thierry Galvez, Ikrame Berkane, Simon Thézenas, Marie-Claude Eberlé, Nicolas Flori, Sophie Guillemard, Alina Diana Ilonca, Lore Santoro, Pierre-Olivier Kotzki, Pierre Senesse and Emmanuel Deshayes

Nutrients 2023, 15(13), 3042; https://doi.org/10.3390/nu15133042 - 5 Jul 2023

Viewed by 2119

Abstract

¹⁸F-FDG PET-CT is routinely performed as part of the initial staging of numerous cancers. Other than having descriptive, predictive and prognostic values for tumors, ¹⁸F-FDG PET-CT provides full-body data, which could inform on concurrent pathophysiological processes such as malnutrition. To test this hypothesis, we measured the ¹⁸F-FDG uptake in several organs and evaluated their association with weight loss in patients at diagnosis of esophageal cancer. Forty-eight patients were included in this retrospective monocentric study. ¹⁸F-FDG uptake quantification was performed in the brain, the liver, the spleen, bone marrow, muscle and the esophageal tumor itself and was compared between patients with different amounts of weight loss. We found that Total Lesion Glycolysis (TLG) and peak Standardized Uptake Values (SUV_peak) measured in the brain correlated with the amount of weight loss: TLG was, on average, higher in patients who had lost more than 5% of their usual weight, whereas brain SUV_peak were, on average, lower in patients who had lost more than 10% of their weight. Higher TLG and lower brain SUV_peak were associated with worse OS in the univariate analysis. This study reports a new and significant association between ¹⁸F-FDG uptake in the brain and initial weight loss in patients with esophageal cancer. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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12 pages, 792 KiB

Open AccessArticle

Obesity Risk of Pediatric Central Nervous System Tumor Survivors: A Cross-Sectional Study

by Rebekah L. Wilson, Jacqueline Soja, Alexandra G. Yunker, Hajime Uno, Erin Gordon, Tabitha Cooney and Christina M. Dieli-Conwright

Nutrients 2023, 15(10), 2269; https://doi.org/10.3390/nu15102269 - 11 May 2023

Cited by 1 | Viewed by 1756

Abstract

Adult survivors of pediatric central nervous system (CNS) tumors are at the highest risk for morbidity and late mortality among all childhood cancers due to a high burden of chronic conditions, and environmental and lifestyle factors. This study aims to epidemiologically characterize young adult survivors of pediatric CNS tumors using body mass index (BMI) to assess risk factors for obesity. Using a cross-sectional design, young adults (18–39 years) previously treated for pediatric CNS tumors and followed in a survivorship clinic during 2016–2021 were examined. Demographic, BMI, and diagnosis information were extracted from medical records of the most recent clinic visit. Data were assessed using a two-sample t-test, Fisher’s exact test, and multivariable logistical regression. 198 survivors (53% female, 84.3% White) with a BMI status of underweight (4.0%), healthy weight (40.9%), overweight (26.8%), obesity (20.2%), and severe obesity (8.1%) were examined. Male sex (OR, 2.414; 95% CI, 1.321 to 4.414), older age at follow-up (OR, 1.103; 95% CI, 1.037 to 1.173), and craniopharyngioma diagnosis (OR, 5.764; 95% CI, 1.197 to 27.751) were identified as significant (p < 0.05) obesity-related (≥25.0 kg/m²) risk factors. The majority of patients were overweight or obese. As such, universal screening efforts with more precise determinants of body composition than BMI, risk stratification, and targeted lifestyle interventions are warranted during survivorship care. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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11 pages, 858 KiB

Open AccessArticle

Impact of Nutritional Status on Postoperative Outcomes in Cancer Patients following Elective Pancreatic Surgery

by Renata Menozzi, Filippo Valoriani, Roberto Ballarin, Luca Alemanno, Martina Vinciguerra, Riccardo Barbieri, Riccardo Cuoghi Costantini, Roberto D’Amico, Pietro Torricelli and Annarita Pecchi

Nutrients 2023, 15(8), 1958; https://doi.org/10.3390/nu15081958 - 19 Apr 2023

Cited by 8 | Viewed by 2698

Abstract

Background: Pancreatic surgery has been associated with important postoperative morbidity, mortality and prolonged length of hospital stay. In pancreatic surgery, the effect of poor preoperative nutritional status and muscle wasting on postsurgery clinical outcomes still remains unclear and controversial. Materials and Methods: A total of 103 consecutive patients with histologically proven carcinoma undergoing elective pancreatic surgery from June 2015 through to July 2020 were included and retrospectively studied. A multidimensional nutritional assessment was performed before elective surgery as required by the local clinical pathway. Clinical and nutritional data were collected in a medical database at diagnosis and after surgery. Results: In the multivariable analysis, body mass index (OR 1.25, 95% CI 1.04–1.59, p = 0.039) and weight loss (OR 1.16, 95% CI 1.06–1.29, p = 0.004) were associated with Clavien score I–II; weight loss (OR 1.13, 95% CI 1.02–1.27, p = 0.027) affected postsurgery morbidity/mortality, and reduced muscle mass was identified as an independent, prognostic factor for postsurgery digestive hemorrhages (OR 0.10, 95% CI 0.01 0.72, p = 0.03) and Clavien score I–II (OR 7.43, 95% CI 1.53–44.88, p = 0.018). No association was identified between nutritional status parameters before surgery and length of hospital stay, 30 days reintervention, 30 days readmission, pancreatic fistula, biliary fistula, Clavien score III–IV, Clavien score V and delayed gastric emptying. Conclusions: An impaired nutritional status before pancreatic surgery affects many postoperative outcomes. Assessment of nutritional status should be part of routine preoperative procedures in order to achieve early and appropriate nutritional support in pancreatic cancer patients. Further studies are needed to better understand the effect of preoperative nutritional therapy on short-term clinical outcomes in patients undergoing pancreatic elective surgery. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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16 pages, 1905 KiB

Open AccessArticle

Effects on Serum Hormone Concentrations after a Dietary Phytoestrogen Intervention in Patients with Prostate Cancer: A Randomized Controlled Trial

by Rebecca Ahlin, Natalja P. Nørskov, Sanna Nybacka, Rikard Landberg, Viktor Skokic, Johan Stranne, Andreas Josefsson, Gunnar Steineck and Maria Hedelin

Nutrients 2023, 15(7), 1792; https://doi.org/10.3390/nu15071792 - 6 Apr 2023

Cited by 4 | Viewed by 2637

Abstract

Phytoestrogens have been suggested to have an anti-proliferative role in prostate cancer, potentially by acting through estrogen receptor beta (ERβ) and modulating several hormones. We primarily aimed to investigate the effect of a phytoestrogen intervention on hormone concentrations in blood depending on the ERβ genotype. Patients with low and intermediate-risk prostate cancer, scheduled for radical prostatectomy, were randomized to an intervention group provided with soybeans and flaxseeds (∼200 mg phytoestrogens/d) added to their diet until their surgery, or a control group that was not provided with any food items. Both groups received official dietary recommendations. Blood samples were collected at baseline and endpoint and blood concentrations of different hormones and phytoestrogens were analyzed. The phytoestrogen-rich diet did not affect serum concentrations of testosterone, insulin-like growth factor 1, or sex hormone-binding globulin (SHBG). However, we found a trend of decreased risk of increased serum concentration of estradiol in the intervention group compared to the control group but only in a specific genotype of ERβ (p = 0.058). In conclusion, a high daily intake of phytoestrogen-rich foods has no major effect on hormone concentrations but may lower the concentration of estradiol in patients with prostate cancer with a specific genetic upset of ERβ. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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13 pages, 753 KiB

Open AccessArticle

Malnutrition, Cancer Stage and Gastrostomy Timing as Markers of Poor Outcomes in Gastrostomy-Fed Head and Neck Cancer Patients

by Diogo Sousa-Catita, Cláudia Ferreira-Santos, Paulo Mascarenhas, Cátia Oliveira, Raquel Madeira, Carla Adriana Santos, Carla André, Catarina Godinho, Luís Antunes and Jorge Fonseca

Nutrients 2023, 15(3), 662; https://doi.org/10.3390/nu15030662 - 28 Jan 2023

Cited by 4 | Viewed by 2336

Abstract

For percutaneous endoscopic gastrostomy (PEG)-fed head and neck cancer (HNC) patients, risk markers of poor outcomes may identify those needing more intensive support. This retrospective study aimed to evaluate markers of poor outcomes using TNM-defined stages, initial anthropometry [body mass index (BMI), mid-upper arm circumference (MUAC), tricipital skinfold (TSF), mid-arm muscle circumference (MAMC)] and laboratory data (albumin, transferrin, cholesterol), with 138 patients, 42–94 years old, enrolled. The patients had cancer, most frequently in the larynx (n = 52), predominantly stage IV (n = 109). Stage IVc presented a four times greater death risk than stage I (OR 3.998). Most patients presented low parameters: low BMI (n = 76), MUAC (n = 114), TSF (n = 58), MAMC (n = 81), albumin (n = 47), transferrin (n = 93), and cholesterol (n = 53). In stages I, III, IVa, and IVb, MAMC and PEG-timing were major survival determinants. Each MAMC unit increase resulted in 16% death risk decrease. Additional 10 PEG-feeding days resulted in 1% mortality decrease. Comparing IVa/IVb vs. IVc, albumin and transferrin presented significant differences (p = 0.042; p = 0.008). All parameters decreased as severity of stages increased. HNC patients were malnourished before PEG, with advanced cancer stages, and poor outcomes. Initial MAMC, reflecting lean tissue, significantly increases survival time, highlighting the importance of preserving muscle mass. PEG duration correlated positively with increased survival, lowering death risk by 1% for every additional 10 PEG-feeding days, signaling the need for early gastrostomy. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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13 pages, 1264 KiB

Open AccessArticle

Medium-Chain Fatty Acids and Breast Cancer Risk by Receptor and Pathological Subtypes

by Padmanabha Ganeshkodi Roopashree, Shilpa S. Shetty, Vijith Vittal Shetty and Suchetha Kumari Nalilu

Nutrients 2022, 14(24), 5351; https://doi.org/10.3390/nu14245351 - 16 Dec 2022

Cited by 8 | Viewed by 3185

Abstract

Introduction: Medium-chain fatty acids contain 6–12 carbon atoms and are absorbed directly into the blood vessels, proceeding to the portal vein and, finally, to the liver, where they are immediately utilized for energy. We aimed to determine the medium-chain fatty acid levels in women with and without breast cancer. Materials and Methods: A total of 200 women (100 breast cancer subjects and 100 control subjects) were recruited for the study as per the inclusion and exclusion criteria. Blood samples were collected for biochemical estimations. Fatty acid methyl esters were isolated, and medium-chain fatty acid levels in plasma were analyzed using gas chromatography (GC-FID). Statistical analysis was performed using SPSS 20.0 software; p ≤ 0.05 was considered statistically significant. Results: The fatty acid analysis revealed a significant decrease in the levels of caprylic acid (C:8) and lauric acid (C:12) and a significant increase in the level of capric acid (C:10) in the breast cancer subjects when compared to the control group. The level of caproic acid (C:6) was not significantly increased in the breast cancer subjects. In particular, the HER2- and ER-positive breast cancer subjects showed a decrease in their caprylic acid and lauric acid levels compared to other receptors. Conclusions: The results of the current study imply that lower levels of caprylic and lauric acid may be associated with a higher risk of breast cancer. The relevance of medium-chain fatty acids for preventive and therapeutic interventions will be amplified by further research on the possibility that alteration in a patient’s medium-chain fatty acid composition may mechanistically contribute to disease progression or breast cancer risk. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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13 pages, 585 KiB

Open AccessArticle

Association of Low Handgrip Strength with Chemotherapy Toxicity in Digestive Cancer Patients: A Comprehensive Observational Cohort Study (FIGHTDIGOTOX)

by Pierre Martin, Damien Botsen, Mathias Brugel, Eric Bertin, Claire Carlier, Rachid Mahmoudi, Florian Slimano, Marine Perrier and Olivier Bouché

Nutrients 2022, 14(21), 4448; https://doi.org/10.3390/nu14214448 - 22 Oct 2022

Viewed by 2055

Abstract

In the FIGHTDIGO study, digestive cancer patients with dynapenia experienced more chemotherapy-induced neurotoxicities. FIGHTDIGOTOX aimed to evaluate the relationship between pre-therapeutic handgrip strength (HGS) and chemotherapy-induced dose-limiting toxicity (DLT) or all-grade toxicity in digestive cancer patients. HGS measurement was performed with a Jamar dynamometer. Dynapenia was defined according to EWGSOP2 criteria (<27 kg (men); <16 kg (women)). DLT was defined as any toxicity leading to dose reduction, treatment delay, or permanent discontinuation. We also performed an exploratory analysis in patients below the included population’s median HGS. A total of 244 patients were included. According to EWGSOP2 criteria, 23 patients had pre-therapeutic dynapenia (9.4%). With our exploratory median-based threshold (34 kg for men; 22 kg for women), 107 patients were dynapenic (43.8%). For each threshold, dynapenia was not an independent predictive factor of overall DLT and neurotoxicity. Dynapenic patients according to EWGSOP2 definition experienced more hand-foot syndrome (p = 0.007). Low HGS according to our exploratory threshold was associated with more all-grade asthenia (p = 0.014), anemia (p = 0.006), and asthenia with DLT (p = 0.029). Pre-therapeutic dynapenia was not a predictive factor for overall DLT and neurotoxicity in digestive cancer patients but could be a predictive factor of chemotherapy-induced anemia and asthenia. There is a need to better define the threshold of dynapenia in cancer patients. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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11 pages, 717 KiB

Open AccessArticle

Validation of the Visual/Verbal Analogue Scale of Food Ingesta (Ingesta-VVAS) in Oncology Patients Undergoing Chemotherapy

by Hanneke A. H. Wijnhoven, Loïs van der Velden, Carolina Broek, Marleen Broekhuizen, Patricia Bruynzeel, Antoinette van Breen, Nanda van Oostendorp and Koen de Heer

Nutrients 2022, 14(17), 3515; https://doi.org/10.3390/nu14173515 - 26 Aug 2022

Cited by 3 | Viewed by 2084

Abstract

This study aimed to: (1) externally validate the Visual/Verbal Analogue Scale of food ingesta (ingesta-VVAS) that previously showed good discrimination between oncology patients who ingest more or less energy than required; (2) explore the discriminative properties of other questions. Dietitians performed 322 interviews in 206 adult oncology patients undergoing chemotherapy in two Dutch hospitals, including a 24-h dietary recall, assessment of the ingesta-VVAS and 12 additional questions related to reduced food intake. The ingesta-VVAS score was linearly associated with energy intake as % of Total Energy Expenditure (TEE) (standardized beta = 0.39, p < 0.001), with no differences between groups based on use of oral nutritional supplements, body mass index, in/outpatient setting or sex. The accuracy of the ingesta-VVAS score to predict low energy intake (<75% of TEE) was poor (Area Under the Receiver Operating Characteristic curve (AUC) = 0.668, 95% CI 0.603–0.733). The optimal multivariate model included the ingesta-VVAS score and a question on ‘feeling sick’ (AUC = 0.680, 95% CI 0.615–0.746). In conclusion, in our study the ingesta-VVAS discriminates poorly between oncology patients undergoing chemotherapy who ingest more or less energy than required. Adding a question on feeling sick only slightly improved model performance. Further external validation is warranted. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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Review

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14 pages, 326 KiB

Open AccessReview

Nutritional Management of Patients with Head and Neck Cancer—A Comprehensive Review

by Dinko Martinovic, Daria Tokic, Ema Puizina Mladinic, Mislav Usljebrka, Sanja Kadic, Antonella Lesin, Marino Vilovic, Slaven Lupi-Ferandin, Sasa Ercegovic, Marko Kumric, Josipa Bukic and Josko Bozic

Nutrients 2023, 15(8), 1864; https://doi.org/10.3390/nu15081864 - 13 Apr 2023

Cited by 8 | Viewed by 4263

Abstract

While surgical therapy for head and neck cancer (HNC) is showing improvement with the advancement of reconstruction techniques, the focus in these patients should also be shifting to supportive pre and aftercare. Due to the highly sensitive and anatomically complex region, these patients tend to exhibit malnutrition, which has a substantial impact on their recovery and quality of life. The complications and symptoms of both the disease and the therapy usually make these patients unable to orally intake food, hence, a strategy should be prepared for their nutritional management. Even though there are several possible nutritional modalities that can be administrated, these patients commonly have a functional gastrointestinal tract, and enteral nutrition is indicated over the parenteral option. However, after extensive research of the available literature, it seems that there is a limited number of studies that focus on this important issue. Furthermore, there are no recommendations or guidelines regarding the nutritional management of HNC patients, pre- or post-operatively. Henceforth, this narrative review summarizes the nutritional challenges and management modalities in this particular group of patients. Nonetheless, this issue should be addressed in future studies and an algorithm should be established for better nutritional care of these patients. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

Other

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22 pages, 759 KiB

Open AccessSystematic Review

Neoadjuvant Gastric Cancer Treatment and Associated Nutritional Critical Domains for the Optimization of Care Pathways: A Systematic Review

by Marta Correia, Ines Moreira, Sonia Cabral, Carolina Castro, Andreia Cruz, Bruno Magalhães, Lúcio Lara Santos and Susana Couto Irving

Nutrients 2023, 15(10), 2241; https://doi.org/10.3390/nu15102241 - 9 May 2023

Cited by 1 | Viewed by 2829

Abstract

(1) Background: Gastric cancer patients are known to be at a high risk of malnutrition, sarcopenia, and cachexia, and the latter impairs the patient’s nutritional status during their clinical course and also treatment response. A clearer identification of nutrition-related critical points during neoadjuvant treatment for gastric cancer is relevant to managing patient care and predicting clinical outcomes. The aim of this systematic review was to identify and describe nutrition-related critical domains associated with clinical outcomes. (2) Methods: We performed a systematic review (PROSPERO ID:CRD42021266760); (3) Results: This review included 14 studies compiled into three critical domains: patient-related, clinical-related (disease and treatment), and healthcare-related. Body composition changes during neoadjuvant chemotherapy (NAC) accounted for the early termination of chemotherapy and reduced overall survival. Sarcopenia was confirmed to have an independent prognostic value. The role of nutritional interventions during NAC has not been fully explored. (4) Conclusions: Understanding critical domain exposures affecting nutritional status will enable better clinical approaches to optimize care plans. It may also provide an opportunity for the mitigation of poor nutritional status and sarcopenia and their deleterious clinical consequences. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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15 pages, 1278 KiB

Open AccessSystematic Review

Nutritional Interventions during Chemotherapy for Pancreatic Cancer: A Systematic Review of Prospective Studies

by Marco Cintoni, Futura Grassi, Marta Palombaro, Emanuele Rinninella, Gabriele Pulcini, Agnese Di Donato, Lisa Salvatore, Giuseppe Quero, Giampaolo Tortora, Sergio Alfieri, Antonio Gasbarrini and Maria Cristina Mele

Nutrients 2023, 15(3), 727; https://doi.org/10.3390/nu15030727 - 1 Feb 2023

Cited by 8 | Viewed by 3627

Abstract

Background: Pancreatic cancer incidence is growing, but the prognosis for survival is still poor. Patients with pancreatic cancer often suffer from malnutrition and sarcopenia, two clinical conditions that negatively impact oncological clinical outcomes. The aim of this systematic review was to analyze the impact of different nutritional interventions on clinical outcomes in patients with pancreatic cancer during chemotherapy. Methods: A systematic review of MedLine, EMBASE, and Web of Science was carried out in December 2022, identifying 5704 articles. Titles and abstracts of all records were screened for eligibility based on inclusion criteria, and nine articles were included. Results: All nine articles included were prospective studies, but a meta-analysis could not be performed due to heterogenicity in nutritional intervention. This Systematic Review shows an improvement in Quality of Life, nutritional status, body composition, oral intake, and Karnofsky Performance Status, following nutritional interventions. Conclusions: This Systematic Review in pancreatic cancer patients during chemotherapies does not allow one to draw firm conclusions. However, nutritional support in pancreatic cancer patients is advisable to ameliorate oncological care. Further well-designed prospective studies are needed to identify nutritional support’s real impact and to establish a reliable way to improve nutritional status of pancreatic cancer patients during chemotherapy. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer)

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