title: Preoperative nutritional support in cancer patients with no clinical signs of malnutrition--prospective randomized controlled trial.
abstract: OBJECTIVE
  Preoperative nutrition is beneficial for malnourished cancer patients. Yet, there is little evidence whether or not it should be given to nonmalnourished patients. The aim of this study was to assess the need to introduce preoperative nutritional support in patients without malnutrition at qualification for surgery.
  
  
  METHODS
  This was a prospective, two-arm, randomized, controlled, open-label study. Patients in interventional group received nutritional supplementation for 14 days before surgery, while control group kept on to their everyday diet. Each patient's nutritional status was assessed twice--at qualification (weight loss in 6 months, laboratory parameters: albumin, total protein, transferrin, and total lymphocyte count) and 1 day before surgery (change in body weight and laboratory parameters). After surgery, all patients were followed up for 30 days for postoperative complications.
  
  
  RESULTS
  Fifty-four patients in interventional and 48 in control group were analyzed. In postoperative period, patients in control group suffered from significantly higher (p < 0.001) number of serious complications compared with patients receiving nutritional supplementation. Moreover, levels of all laboratory parameters declined significantly (p < 0.001) in these patients, while in interventional arm were stable (albumin and total protein) or raised (transferrin and total lymphocyte count).
  
  
  CONCLUSIONS
  Preoperative nutritional support should be introduced for nonmalnourished patients as it helps to maintain proper nutritional status and reduce number and severity of postoperative complications compared with patients without such support.
authors.affiliation: Department of Surgical Oncology, Medical University of Gdańsk, Smoluchowskiego 17, 80-952, Gdańsk, Poland, pawel.kabata@gmail.com.
authors.forename: Paweł
authors.initials: P
authors.lastname: Kabata
authors.forename: Tomasz
authors.initials: T
authors.lastname: Jastrzębski
authors.forename: Michał
authors.initials: M
authors.lastname: Kąkol
authors.forename: Karolina
authors.initials: K
authors.lastname: Król
authors.forename: Maciej
authors.initials: M
authors.lastname: Bobowicz
authors.forename: Anna
authors.initials: A
authors.lastname: Kosowska
authors.forename: Janusz
authors.initials: J
authors.lastname: Jaśkiewicz
mesh_terms: D000328:Adult; D000368:Aged; D002100:Cachexia / Q000209:etiology; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D011446:Prospective Studies; D015431:Weight Loss
references.citation: Nutrition. 2010 Nov-Dec;26(11-12):1088-93
references.pmid: 19963351
references.citation: Arch Surg. 2002 Feb;137(2):174-80
references.pmid: 11822956
references.citation: Scand J Surg. 2010;99(3):153-61
references.pmid: 21044933
references.citation: Nutrients. 2012 Sep;4(9):1230-6
references.pmid: 23112911
references.citation: Dis Colon Rectum. 2003 May;46(5):653-60
references.pmid: 12792443
references.citation: World J Surg. 2009 Aug;33(8):1633-40
references.pmid: 19387725
references.citation: Nutrition. 2013 May;29(5):724-9
references.pmid: 23352174
references.citation: Surg Today. 2006;36(12):1063-8
references.pmid: 17123134
references.citation: Cochrane Database Syst Rev. 2012 Nov 14;11:CD008879
references.pmid: 23152265
references.citation: Curr Opin Clin Nutr Metab Care. 2001 Nov;4(6):541-6
references.pmid: 11706291
references.citation: Lancet. 2001 Nov 3;358(9292):1487-92
references.pmid: 11705560
references.citation: Am J Clin Nutr. 2001 Oct;74(4):534-42
references.pmid: 11566654
references.citation: Eur J Oncol Nurs. 2005;9 Suppl 2:S39-50
references.pmid: 16437757
references.citation: Clin Nutr. 2011 Dec;30(6):708-13
references.pmid: 21820770
references.citation: Gastroenterology. 2002 Jun;122(7):1763-70
references.pmid: 12055582
references.citation: J Urol. 2011 Jan;185(1):90-6
references.pmid: 21074802
references.citation: Clin Nutr. 2012 Jun;31(3):293-312
references.pmid: 22257636