Aktuelle Ernährungsmedizin 2017; 42(03): 241-272
DOI: 10.1055/s-0037-1603292
Poster
Georg Thieme Verlag KG Stuttgart · New York

OUTCOME AFTER PREOPERATIVE IMMUNONUTRITION IN HEAD AND NECK SQUAMOUS CELL CARCINOMA PATIENTS

C Aeberhard
1   Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism
,
C Mayer
1   Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism
,
S Meyer
1   Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism
,
S Müller
2   Department of ORL, Head and Neck Surgery, University Hospital and University of Bern, Bern
,
P Schütz
3   Department of Endocrinology, Diabetes and Clinical Nutrition, University Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
,
Z Stanga
1   Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism
,
R Giger
2   Department of ORL, Head and Neck Surgery, University Hospital and University of Bern, Bern
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
20. Juni 2017 (online)

Auch verfügbar aufeRef
 

Introduction:

Perioperative disease-related malnutrition results in compromised wound healing, reduced immunologic functions, increased susceptibility to infections and decreased tolerance to further treatment, leading to a prolonged hospital stay and a poorer prognosis. Patients with head and neck squamous cell carcinoma (HNSCC) are specifically at risk for nutritional deficiencies.

Objectives:

The aim of the study was to evaluate the effect of preoperative immunonutrition (IN) on postoperative short-term outcomes in patients with HNSCC undergoing elective oncologic surgery.

Methods:

Single centre before and after study was conducted to compare clinical outcomes of consecutive patients before (control group) and after implementation (intervention group) of preoperative IN, given for 5 days preoperatively. Regression models adjusted for important outcome predictors were used to compare length of hospital stay (LOS), local infections and general complications (Buzby and Dindo classification).

Results:

A total of 411 patients were included (control group: 209, intervention group: 202). The LOS was significantly lower in patients receiving IN compared with the control gorup (median 6 vs. 8 days, p < 0. 001). Local wound infections were significantly reduced after IN was implemented (7.4% vs. 15.3%, p = 0.006). Specifically, there was a significantly lower rate for local wound complications, such as abscesses (4. 5% vs. 7. 7%, p = 0. 031) and fistulas (3. 5% vs. 6. 2%, p = 0. 009). Subgroup analysis showed more pronounced effects in patients with previous irradiation and extensive surgeries.

Conclusion:

Data about the impact of preoperative IN on postoperative outcome in HNSCC patients are scarce. Patients receiving preoperative IN had a shorter LOS and a lower rate for wound infections and local complications compared with control group, whose effects remained robust after a multivariate adjustment. Further randomized controlled trials may be needed to confirm our results and to give evidence based recommendations.

Disclosure of Interest:

None declared.