Long-Term Survival Associated with Direct Oral Feeding Following Minimally Invasive Esophagectomy: Results from a Randomized Controlled Trial (NUTRIENT II)

Advancements in perioperative care have improved postoperative morbidity and recovery after esophagectomy. The direct start of oral intake can also enhance short-term outcomes following minimally invasive Ivor Lewis esophagectomy (MIE-IL). Subsequently, short-term outcomes may affect long-term survi...

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Bibliographic Details
Published in:Cancers 2023-10, Vol.15 (19), p.4856
Main Authors: Geraedts, Tessa C. M, Weijs, Teus J, Berkelmans, Gijs H. K, Fransen, Laura F. C, Kouwenhoven, Ewout A, van Det, Marc J, Nilsson, Magnus, Lagarde, Sjoerd M, van Hillegersberg, Richard, Markar, Sheraz R, Nieuwenhuijzen, Grard A. P, Luyer, Misha D. P
Format: Article
Language:English
Subjects:
Clinical trials
Comparative analysis
Complications
Esophageal cancer
Feeding
Morbidity
Mortality
Netherlands
Ostomy
Patients
Postoperative
Recovery (Medical)
Software
Surgery
Surgical anastomosis
Survival
Sweden
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Summary:Advancements in perioperative care have improved postoperative morbidity and recovery after esophagectomy. The direct start of oral intake can also enhance short-term outcomes following minimally invasive Ivor Lewis esophagectomy (MIE-IL). Subsequently, short-term outcomes may affect long-term survival. This planned sub-study of the NUTRIENT II trial, a multicenter randomized controlled trial, investigated the long-term survival of direct versus delayed oral feeding following MIE-IL. The outcomes included 3- and 5-year overall survival (OS) and disease-free survival (DFS), and the influence of complications and caloric intake on OS. After excluding cases of 90-day mortality, 145 participants were analyzed. Of these, 63 patients (43.4%) received direct oral feeding. At 3 years, OS was significantly better in the direct oral feeding group (p = 0.027), but not at 5 years (p = 0.115). Moreover, 5-year DFS was significantly better in the direct oral feeding group (p = 0.047) and a trend towards improved DFS was shown at 3 years (p = 0.079). Postoperative complications and caloric intake on day 5 did not impact OS. The results of this study show a tendency of improved 3-year OS and 5-year DFS, suggesting a potential long-term survival benefit in patients receiving direct oral feeding after esophagectomy. However, the findings should be further explored in larger future trials.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15194856