QUALITY OF LIFE FOLLOWING PERIOPERATIVE OPTIMIZATION WITH NUTRITIONAL SUPPLEMENTS IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY FOR CANCER: A SECONDARY ANALYSIS OF RANDOMIZED, PLACEBO-CONTROLLED FEASIBILITY CLINICAL TRIAL
Christopher D. Griffiths*, Daniel D'Souza, Felipe Rodriguez, Lily J. Park, Pablo E. Serrano
General Surgery, McMaster University, Hamilton, ON, Canada
Introduction: Up to two thirds of patients presenting for surgery are malnourished pre-operatively, with higher incidence amongst oncology patients. Perioperative nutritional supplementation has been proposed to improve surgical outcomes, though its effect on quality of life (QoL) has not yet been studied.
Methods: A prospective, randomized controlled feasibility trial for perioperative nutrition among patients undergoing major abdominal surgery for gastrointestinal tract cancers was conducted. Patients in the intervention group received supplements for thirty days until the day of surgery. Patients completed two QoL questionnaires (EORTC QLQ LMC-21 and FACT-G) on the day of surgery, four, and twelve weeks postoperatively. Patients were compared between groups and within groups at baseline, week 4 and 12 using t-tests. Minimal important clinical differences (MICD) were considered as a 10-point difference from baseline.
Results: 71 patients were included in this analysis, including 36 in the intervention and 35 in control. Baseline demographics were balanced between groups except for different rates of pancreas cancer (36% intervention vs 9% control) and colorectal cancer (19% intervention vs 34% control) between groups. On the day of surgery, patients in the intervention group had higher QoL (77% vs 59%, p=0.01), role functioning (88% vs 72%, p=0.045), and cognitive functioning (90% vs 79%, p=0.047). Following surgery, however, there were no significant differences in QoL according to either QoL score between groups. The rates of MICD were similar between both intervention and control groups at week 4 and 12 post-operatively and all scores returned to baseline by week 12 in both groups.
Discussion: Perioperative nutrition leads to improved QoL in those preparing for surgery; however, improvements do not appear to persist following surgery.
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