The effect of perioperative immunonutritional support on nutritional and inflammatory status in patients undergoing lung cancer surgery: a prospective, randomized controlled study


Gunsel-Yildirim G., Ceylan K. C., DİKMEN D.

Supportive Care in Cancer, vol.31, no.6, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 6
  • Publication Date: 2023
  • Doi Number: 10.1007/s00520-023-07838-9
  • Journal Name: Supportive Care in Cancer
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Keywords: Immunonutrition, Inflammation, Lung cancer surgery, Nutritional status, Physical performance
  • Hacettepe University Affiliated: Yes

Abstract

Purpose: Nutritional status is affected in patients who undergo lung cancer surgery (LCS). This study is aimed at investigating the effects of the use of immunonutritional support in the perioperative period on nutritional and inflammatory status in patients undergoing LCS. Methods: A single-center, prospective, randomized controlled clinical trial was conducted with seventy patients planning to have LCS and randomized into treatment (TG) and control groups (CG). Immunonutritional support was given orally twice a day for ten days before the operation and five days after the operation in the treatment group. The nutritional status of the patients was screened with the Patient-Generated Subjective Global Assessment (PG-SGA); the Prognostic Nutrition Index (PNI) and the Systemic Inflammation Index (SII) were calculated. The physical activity status was assessed with the Eastern Cooperative Oncology Group Performance Status (ECOG-PS). Results: Post-op nutritional status of the TG patients was better than the CG group (p = 0.009). Post-operative PG-SGA score was higher than preoperative PG-SGA score in both groups (p < 0.001). In the post-operative period, nutritional status (in terms of PG-SGA score category) in the patients in the TG was better than the CG (p = 0.046). In both groups, post-op ECOG score was higher than the pre-op ECOG score (p < 0.001). Post-op physical performance status was found to be better in the TG compared to the CG (p = 0.001). PNI level decreased statistically and significantly in the post-op period compared to the pre-op period, SII levels increased. Conclusion: Patients who will undergo LCS should be supported in terms of immunonutrition starting from the preoperative period.