Enriched enteral nutrition may improve short-term survival in stage IV gastric cancer patients: A randomized, controlled trial.
OBJECTIVE
The aim of the study was to determine whether the postoperative use of enteral nutrition enriched with arginine, glutamine, and omega-3 fatty acids influences survival in patients diagnosed with stomach cancer. For the purpose of the study, the second wave of the trial performed in 2003 to 2009 was done.


METHODS
Ninety-nine patients who underwent surgery for gastric cancer (27 F, 72 M, mean age: 62.9 y) met the inclusion criteria. Of those, 54 were randomized to standard and 45 to enriched enteral nutrition (EEN). In all patients, short- and long-term (5 y) survival was analyzed.


RESULTS
Analysis of the overall survival time did not reveal differences between groups (P = 0.663). Until the end of the third month, however, there were nine deaths in the standard enteral nutrition group and no deaths in the EEN group (16.7% versus 0.0%, P = 0.004). The univariate analyses suggested that the EEN group may have lower risk, especially during the first year after intervention. A significant reduction in the risk of death was seen during the early period after surgery (first 6 mo) in the EEN group in stage IV patients (hazard ratio = 0.25, P = 0.049). The use of enriched enteral diet did not influence, however, the risk of dying when patients were analyzed together.


CONCLUSIONS
The study does not support the beneficial effect of enriched enteral nutrition in long-term survival; however, the positive impact on the stage IV patients suggests the need for further, more detailed studies.
Stanley Dudrick's Memorial Hospital, General Surgery Unit, Skawina, Poland. Electronic address: klek@poczta.onet.pl.
Stanislaw
S
Klek
Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Care, Jagiellonian University, Krakow, Poland.
Lucyna
L
Scislo
Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Care, Jagiellonian University, Krakow, Poland.
Elzbieta
E
Walewska
Stanley Dudrick's Memorial Hospital, General Surgery Unit, Skawina, Poland.
Ryszard
R
Choruz
Department of Epidemiology, Jagiellonian University Medical College, Krakow, Poland.
Aleksander
A
Galas
D000368:Aged; D001120:Arginine / Q000008:administration & dosage; D015992:Body Mass Index; D004311:Double-Blind Method; D004750:Enteral Nutrition; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D005973:Glutamine / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011184:Postoperative Period; D018401:Sample Size; D013270:Stomach / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000628:therapy*; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3; D005973:Glutamine; D001120:Arginine
Enteral nutrition; Gastric cancer; Immunonutrition; Postoperative nutrition