Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomized clinical trial.
OBJECTIVE
This study evaluated the use of perioperative nutritional support on Quality of Life (QOL) in malnourished head and neck cancer patients undergoing surgery.


METHODS
49 Malnourished (weight loss >10%) head and neck cancer patients who were included in a nutrition intervention trial were randomized to receive either no preoperative and standard postoperative tube-feeding (group I), standard preoperative and postoperative tube-feeding (group II) or arginine-supplemented preoperative and postoperative tube-feeding (group III). Of these patients, 31 completed a full QOL assessment on the first day of preoperative nutritional support, one day before surgery, and 6 months after surgery. Both a disease-specific (EORTC QLQ-C30) and a generic questionnaire (COOP-WONCA) were used. One way analysis of variance (ANOVA) and the Kruskal-Wallis test were applied for testing differences in scores between groups.


RESULTS
Between baseline and the day before surgery, both preoperatively fed groups revealed a positive change for the dimensions physical and emotional functioning and dyspnea (with significance in group II, P=0.050,0.031,0.045 respectively). Group III showed a negative change in appetite (P=0.049). Between baseline and 6 months after surgery, there were no differences between group I and both pre-fed groups. There were no differences in favour of group III compared to group II.


CONCLUSIONS
Enteral nutrition improves QOL of severely malnourished head and neck cancer patients in the period preceding surgery. No benefit of preoperative enteral feeding on QOL could be demonstrated 6 months after surgery.
Van Bokhorst-de Van der Schuer
M A
MA
Dept of Dietetics, Nutrition Support Team, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Langendoen
S I
SI
Vondeling
H
H
Kuik
D J
DJ
Quak
J J
JJ
Van Leeuwen
P A
PA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications / Q000628:therapy*; D009752:Nutritional Status; D019990:Perioperative Care; D011788:Quality of Life; D011795:Surveys and Questionnaires