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Cited by 186Clinical Nutrition and GastroenterologyNutrition and Health in AgingEnhanced Recovery After Surgery

Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: secondary analysis of a prospective randomized trial

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Bargetzi, L., Brack, C., Herrmann, J., Bargetzi, A., Hersberger, L., Bargetzi, M., Kaegi-Braun, N., Tribolet, P. +16 more·2021·Annals of Oncology
DOI 10.1016/j.annonc.2021.05.793
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Abstract

Background Nutritional support in patients with cancer aims at improving quality of life. Whether use of nutritional support is also effective in improving clinical outcomes requires further study. Patients and methods In this preplanned secondary analysis of patients with cancer included in a prospective, randomized-controlled, Swiss, multicenter trial (EFFORT), we compared protocol-guided individualized nutritional support (intervention group) to standard hospital food (control group) regarding mortality at 30-day (primary endpoint) and other clinical outcomes. Results We analyzed 506 patients with a main admission diagnosis of cancer, including lung cancer (n = 113), gastrointestinal tumors (n = 84), hematological malignancies (n = 108) and other types of cancer (n = 201). Nutritional risk based on Nutritional Risk Screening (NRS 2002) was an independent predictor for mortality over 180 days with an (age-, sex-, center-, type of cancer-, tumor activity- and treatment-) adjusted hazard ratio of 1.29 (95% CI 1.09-1.54; P = 0.004) per point increase in NRS. In the 30-day follow-up period, 50 patients (19.9%) died in the control group compared to 36 (14.1%) in the intervention group resulting in an adjusted odds ratio of 0.57 (95% CI 0.35-0.94; P = 0.027). Interaction tests did not show significant differences in mortality across the cancer type subgroups. Nutritional support also significantly improved functional outcomes and quality of life measures. Conclusions Compared to usual hospital nutrition without nutrition support, individualized nutritional support reduced the risk of mortality and improved functional and quality of life outcomes in cancer patients with increased nutritional risk. These data further support the inclusion of nutritional care in cancer management guidelines.

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  • Other conditions which may increase the effects of nutritional support are cancer and COPD.

    “Other conditions which may increase the effects of nutritional support are cancer [171], COPD [39] among others.”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [171]

    The Discussion (page unavailable) reports a strong benefit of nutritional support in hospitalized patients with cancer, including lower 30-day mortality. It does not establish that cancer increases the effect relative to patients without cancer. The COPD portion is attributed to a different citation and is not assessed here. (LLM, conf=0.78)

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Authors
Bargetzi, L., Brack, C., Herrmann, J., Bargetzi, A., Hersberger, L., Bargetzi, M., Kaegi-Braun, N., Tribolet, P., Gomes, F., Hoess, C., Pavlicek, V., Bilz, S., Sigrist, S., Brändle, M., Henzen, C., Thomann, R., Rutishauser, J., Aujesky, D., Rodondi, N., Donzé, J., Laviano, A., Stanga, Z., Mueller, B., & Schuetz, P.
Affiliations
  • University of Basel (CH)
  • Kantonsspital Aarau (CH)
  • Bern University of Applied Sciences (CH)
  • New York Academy of Sciences (US)
  • Kantonsspital Münsterlingen (CH)
  • Kantonsspital St. Gallen (CH)
  • Luzerner Kantonsspital (CH)
  • Kantonsspital Baselland (CH)
  • University of Bern (CH)
  • Sapienza University of Rome (IT)
ORCID
Venue
Annals of Oncology
Publisher
Elsevier BV
Published
2021-08
Volume
32
Issue
8
Pages
1025-1033
ISSN
0923-7534 (ISSN-L)
DOI
10.1016/j.annonc.2021.05.793
OpenAlex
W3163053079
Cited by
186
References
5
Citations by year
2026: 31 · 2025: 33 · 2024: 36 · 2023: 37 · 2022: 36 · 2021: 13
FWCI
19.44
Type
journal article
Language
en
Open access
Licence
Locations
  • Annals of Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • ARBOR - Bern University of Applied Sciences Repository (submittedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by-nc-nd)
Funders
Swiss National Science Foundation
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
Keywords
nutritional support, cancer patients, in-hospital mortality, NRS-2002, nutritional risk, individualized nutritional support, hospital food, functional outcome, quality of life, lung cancer, gastrointestinal cancer, hematologic malignancies
MeSH terms
Humans, Length of Stay, Prospective Studies, Quality of Life, Nutritional Support, Hematologic Neoplasms

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