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Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE)

Abstract Background Improved preoperative immunonutrition has been shown to decrease the length of stay (LOS) and complications among patients undergoing elective gastrointestinal cancer surgeries. The purpose of this study was to determine whether preoperative immunonutrition supplementation decrea...

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Published in:European journal of surgical oncology 2017-04, Vol.43 (4), p.772-779
Main Authors: Martin, R.C.G, Agle, S, Schlegel, M, Hayat, T, Scoggins, C.R, McMasters, K.M, Philips, P
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container_title European journal of surgical oncology
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description Abstract Background Improved preoperative immunonutrition has been shown to decrease the length of stay (LOS) and complications among patients undergoing elective gastrointestinal cancer surgeries. The purpose of this study was to determine whether preoperative immunonutrition supplementation decreases postoperative LOS, infectious complications, and morbidity in patients undergoing irreversible electroporation (IRE) surgery for locally advanced pancreatic cancer (LAPC). Methods At a regional hepatopancreatobiliary referral center within an academic medical center 71 patients receiving IRE treatment of LAPC were included in the study. The participants were divided into those receiving preoperative immunonutrition (n=44) and those receiving no supplemental preoperative immunonutrition (n=27). Main outcomes and measures were LOS, postoperative complications, nutritional risk index (NRI), and albumin levels. Results Patients in both groups were similar for preoperative nutrition parameters and operative therapy. Patients in the immunonutrition group experienced a statistically significant decrease in postoperative complications (p=0.05) and LOS (10.7 vs. 17.4, p=0.01), and less of a decrease in nutritional risk index (-12.6 vs. -16.2, p=0.03) and albumin levels (-1.1 vs. -1.5, p
doi_str_mv 10.1016/j.ejso.2017.01.002
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The purpose of this study was to determine whether preoperative immunonutrition supplementation decreases postoperative LOS, infectious complications, and morbidity in patients undergoing irreversible electroporation (IRE) surgery for locally advanced pancreatic cancer (LAPC). Methods At a regional hepatopancreatobiliary referral center within an academic medical center 71 patients receiving IRE treatment of LAPC were included in the study. The participants were divided into those receiving preoperative immunonutrition (n=44) and those receiving no supplemental preoperative immunonutrition (n=27). Main outcomes and measures were LOS, postoperative complications, nutritional risk index (NRI), and albumin levels. Results Patients in both groups were similar for preoperative nutrition parameters and operative therapy. Patients in the immunonutrition group experienced a statistically significant decrease in postoperative complications (p=0.05) and LOS (10.7 vs. 17.4, p=0.01), and less of a decrease in nutritional risk index (-12.6 vs. -16.2, p=0.03) and albumin levels (-1.1 vs. -1.5, p&lt;0.01). Conclusion Preoperative immunonutrition was clinically significant in decreasing postoperative complications, LOS, and improving post-surgery NRI and albumin levels in patients receiving elective IRE treatment of non-resectable pancreatic cancer. These results indicate that preoperative immunonutrition is effective and feasible in this subset of cancer patients.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2017.01.002</identifier><identifier>PMID: 28162818</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Ablation Techniques ; Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Amino Acids, Branched-Chain - therapeutic use ; Arginine - therapeutic use ; Dietary Supplements ; Electroporation ; Enteral Nutrition - methods ; Fatty Acids, Omega-3 - therapeutic use ; Female ; Glutamine - therapeutic use ; Hematology, Oncology and Palliative Medicine ; Humans ; Immunomodulation ; Irreversible electroporation (IRE) ; Male ; Middle Aged ; Morbidity ; Mortality ; Nucleotides - therapeutic use ; Nutritional Status ; Pancreatic cancer ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - therapy ; Pilot Projects ; Postoperative Complications - prevention &amp; control ; Preoperative Care - methods ; Preoperative nutrition ; Surgery ; Treatment Outcome ; Weight Loss</subject><ispartof>European journal of surgical oncology, 2017-04, Vol.43 (4), p.772-779</ispartof><rights>Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-774f23eaad0f70171be3a7d5cd89cb881523292b106bf0755a3c34ee8893d2bc3</citedby><cites>FETCH-LOGICAL-c411t-774f23eaad0f70171be3a7d5cd89cb881523292b106bf0755a3c34ee8893d2bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28162818$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martin, R.C.G</creatorcontrib><creatorcontrib>Agle, S</creatorcontrib><creatorcontrib>Schlegel, M</creatorcontrib><creatorcontrib>Hayat, T</creatorcontrib><creatorcontrib>Scoggins, C.R</creatorcontrib><creatorcontrib>McMasters, K.M</creatorcontrib><creatorcontrib>Philips, P</creatorcontrib><title>Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE)</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Abstract Background Improved preoperative immunonutrition has been shown to decrease the length of stay (LOS) and complications among patients undergoing elective gastrointestinal cancer surgeries. The purpose of this study was to determine whether preoperative immunonutrition supplementation decreases postoperative LOS, infectious complications, and morbidity in patients undergoing irreversible electroporation (IRE) surgery for locally advanced pancreatic cancer (LAPC). Methods At a regional hepatopancreatobiliary referral center within an academic medical center 71 patients receiving IRE treatment of LAPC were included in the study. The participants were divided into those receiving preoperative immunonutrition (n=44) and those receiving no supplemental preoperative immunonutrition (n=27). Main outcomes and measures were LOS, postoperative complications, nutritional risk index (NRI), and albumin levels. Results Patients in both groups were similar for preoperative nutrition parameters and operative therapy. Patients in the immunonutrition group experienced a statistically significant decrease in postoperative complications (p=0.05) and LOS (10.7 vs. 17.4, p=0.01), and less of a decrease in nutritional risk index (-12.6 vs. -16.2, p=0.03) and albumin levels (-1.1 vs. -1.5, p&lt;0.01). Conclusion Preoperative immunonutrition was clinically significant in decreasing postoperative complications, LOS, and improving post-surgery NRI and albumin levels in patients receiving elective IRE treatment of non-resectable pancreatic cancer. 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control</subject><subject>Preoperative Care - methods</subject><subject>Preoperative nutrition</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Weight Loss</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kU-L1TAUxYMoznP0C7iQLMdFa_60TQoiDMNTBwYGRgV3IU1vh9Q0qUn74IEf3pQ3upjFLC4XLuccuL-D0FtKSkpo82EsYUyhZISKktCSEPYM7WjNWcFoLZ6jHRGVLEQr-Rl6ldJICGm5aF-iMyZpk0fu0J_9MFijzRGHAc8RwgxRL_YA2E7T6oNfl2gXGzy2HrtgtHNHrPuD9gZ6POcVIesNNtsl4tX3EO-D9ffYxggHiMl2DjA4MEsMc9jSc9rF9d3-_Wv0YtAuwZuHfY5-fN5_v_pa3Nx-ub66vClMRelSCFENjIPWPRlEfpZ2wLXoa9PL1nRS0ppx1rKOkqYbiKhrzQ2vAKRsec86w8_RxSl3juH3CmlRk00GnNMewpoUlU1dc85Jk6XsJDUxpBRhUHO0k45HRYnaqKtRbdTVRl0RqjL1bHr3kL92E_T_Lf8wZ8HHkwDylwcLUSVjYUNoY-ai-mCfzv_0yG6c9bk29wuOkMawRp_5KaoSU0R923rfaqeCE1I1P_lfb7OrHA</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Martin, R.C.G</creator><creator>Agle, S</creator><creator>Schlegel, M</creator><creator>Hayat, T</creator><creator>Scoggins, C.R</creator><creator>McMasters, K.M</creator><creator>Philips, P</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE)</title><author>Martin, R.C.G ; Agle, S ; Schlegel, M ; Hayat, T ; Scoggins, C.R ; McMasters, K.M ; Philips, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-774f23eaad0f70171be3a7d5cd89cb881523292b106bf0755a3c34ee8893d2bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Ablation Techniques</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amino Acids, Branched-Chain - therapeutic use</topic><topic>Arginine - therapeutic use</topic><topic>Dietary Supplements</topic><topic>Electroporation</topic><topic>Enteral Nutrition - methods</topic><topic>Fatty Acids, Omega-3 - therapeutic use</topic><topic>Female</topic><topic>Glutamine - therapeutic use</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Immunomodulation</topic><topic>Irreversible electroporation (IRE)</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Nucleotides - therapeutic use</topic><topic>Nutritional Status</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - therapy</topic><topic>Pilot Projects</topic><topic>Postoperative Complications - prevention &amp; control</topic><topic>Preoperative Care - methods</topic><topic>Preoperative nutrition</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martin, R.C.G</creatorcontrib><creatorcontrib>Agle, S</creatorcontrib><creatorcontrib>Schlegel, M</creatorcontrib><creatorcontrib>Hayat, T</creatorcontrib><creatorcontrib>Scoggins, C.R</creatorcontrib><creatorcontrib>McMasters, K.M</creatorcontrib><creatorcontrib>Philips, P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martin, R.C.G</au><au>Agle, S</au><au>Schlegel, M</au><au>Hayat, T</au><au>Scoggins, C.R</au><au>McMasters, K.M</au><au>Philips, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE)</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>43</volume><issue>4</issue><spage>772</spage><epage>779</epage><pages>772-779</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>Abstract Background Improved preoperative immunonutrition has been shown to decrease the length of stay (LOS) and complications among patients undergoing elective gastrointestinal cancer surgeries. The purpose of this study was to determine whether preoperative immunonutrition supplementation decreases postoperative LOS, infectious complications, and morbidity in patients undergoing irreversible electroporation (IRE) surgery for locally advanced pancreatic cancer (LAPC). Methods At a regional hepatopancreatobiliary referral center within an academic medical center 71 patients receiving IRE treatment of LAPC were included in the study. The participants were divided into those receiving preoperative immunonutrition (n=44) and those receiving no supplemental preoperative immunonutrition (n=27). Main outcomes and measures were LOS, postoperative complications, nutritional risk index (NRI), and albumin levels. Results Patients in both groups were similar for preoperative nutrition parameters and operative therapy. Patients in the immunonutrition group experienced a statistically significant decrease in postoperative complications (p=0.05) and LOS (10.7 vs. 17.4, p=0.01), and less of a decrease in nutritional risk index (-12.6 vs. -16.2, p=0.03) and albumin levels (-1.1 vs. -1.5, p&lt;0.01). Conclusion Preoperative immunonutrition was clinically significant in decreasing postoperative complications, LOS, and improving post-surgery NRI and albumin levels in patients receiving elective IRE treatment of non-resectable pancreatic cancer. These results indicate that preoperative immunonutrition is effective and feasible in this subset of cancer patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28162818</pmid><doi>10.1016/j.ejso.2017.01.002</doi><tpages>8</tpages></addata></record>
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subjects Ablation Techniques
Adenocarcinoma - pathology
Adenocarcinoma - therapy
Adult
Aged
Aged, 80 and over
Amino Acids, Branched-Chain - therapeutic use
Arginine - therapeutic use
Dietary Supplements
Electroporation
Enteral Nutrition - methods
Fatty Acids, Omega-3 - therapeutic use
Female
Glutamine - therapeutic use
Hematology, Oncology and Palliative Medicine
Humans
Immunomodulation
Irreversible electroporation (IRE)
Male
Middle Aged
Morbidity
Mortality
Nucleotides - therapeutic use
Nutritional Status
Pancreatic cancer
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - therapy
Pilot Projects
Postoperative Complications - prevention & control
Preoperative Care - methods
Preoperative nutrition
Surgery
Treatment Outcome
Weight Loss
title Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE)
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