Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2017

10.11.2016 | Gynecologic Oncology

The impact of total parenteral nutrition on postoperative recovery in patients treated for advanced stage ovarian cancer

verfasst von: Alberto A. Mendivil, Mark A. Rettenmaier, Lisa N. Abaid, John V. Brown III, Kristina M. Mori, Bram H. Goldstein

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Total parenteral nutrition (TPN) presumably benefits cancer patients although reports have disputed the significance of this nutritional intervention. We sought to compare the postoperative outcomes of ovarian cancer patients treated with either TPN or conservative management.

Methods

We retrospectively evaluated the impact of TPN and conservative management in ovarian cancer patients who underwent debulking surgery and a bowel resection. The primary study variables encompassed patient time until restoration of bowel function, number of postoperative complications and duration of hospital stay.

Results

There were 147 subjects who were selected for this study. The patients who were treated with TPN (n = 69) demonstrated a longer time until restoration of bowel function (5.77 vs. 4.70 days; P < 0.001), experienced lower pre-operative albumin levels (2.22 vs. 2.97 g/dL; P < 0.001) and endured a significantly longer hospital stay (11.46 vs. 7.14 days; P < 0.001) compared to the conservative management (n = 78) cohort.

Conclusions

Postoperative TPN in ovarian cancer patients may be inadvisable because of the increased risk for complications. Moreover, in the hypoalbuminemic patients, TPN may have not only delayed their postoperative recovery and increased hospital stay duration, but further precipitated the manifestation of nosocomial sequelae.
Literatur
1.
Zurück zum Zitat de Luis DA, Culebras JM, Aller R, Eiros-Bouza JM (2014) Surgical infection and malnutrition. Nutr Hosp 30:509–513PubMed de Luis DA, Culebras JM, Aller R, Eiros-Bouza JM (2014) Surgical infection and malnutrition. Nutr Hosp 30:509–513PubMed
2.
Zurück zum Zitat Nussbaum DP, Penne K, Stinnett SS, Speicher PJ, Cocieru A et al (2015) A standardized care plan is associated with shorter hospital length of stay in patients undergoing pancreaticoduodenectomy. J Surg Res 193:237–245CrossRefPubMed Nussbaum DP, Penne K, Stinnett SS, Speicher PJ, Cocieru A et al (2015) A standardized care plan is associated with shorter hospital length of stay in patients undergoing pancreaticoduodenectomy. J Surg Res 193:237–245CrossRefPubMed
3.
Zurück zum Zitat Melbert RB, Kimmins MH, Isler JT, Billingham RP, Lawton D et al (2002) Use of a critical pathway for colon resections. J Gastrointest Surg 6:745–752CrossRefPubMed Melbert RB, Kimmins MH, Isler JT, Billingham RP, Lawton D et al (2002) Use of a critical pathway for colon resections. J Gastrointest Surg 6:745–752CrossRefPubMed
4.
Zurück zum Zitat Hoda D, Jatoi A, Burnes J, Loprinzi C, Kelly D (2005) Should patients with advanced, incurable cancers ever be sent home with total parenteral nutrition? A single institution’s 20-year experience. Cancer 103:863–868CrossRefPubMed Hoda D, Jatoi A, Burnes J, Loprinzi C, Kelly D (2005) Should patients with advanced, incurable cancers ever be sent home with total parenteral nutrition? A single institution’s 20-year experience. Cancer 103:863–868CrossRefPubMed
5.
Zurück zum Zitat Balogun N, Forbes A, Widschwendter M, Lanceley A (2012) Noninvasive nutritional management of ovarian cancer patients: beyond intestinal obstruction. Int J Gynecol Cancer 22:1089–1095CrossRefPubMed Balogun N, Forbes A, Widschwendter M, Lanceley A (2012) Noninvasive nutritional management of ovarian cancer patients: beyond intestinal obstruction. Int J Gynecol Cancer 22:1089–1095CrossRefPubMed
6.
Zurück zum Zitat Baker J, Janda M, Graves N, Bauer J, Banks M et al (2015) Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: results from a randomised trial. Gynecol Oncol 137:516–522CrossRefPubMed Baker J, Janda M, Graves N, Bauer J, Banks M et al (2015) Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: results from a randomised trial. Gynecol Oncol 137:516–522CrossRefPubMed
7.
Zurück zum Zitat Laky B, Janda M, Kondalsamy-Chennakesavan S, Cleghorn G, Obermair A (2010) Pretreatment malnutrition and quality of life—association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study. BMC Cancer 10:232CrossRefPubMedPubMedCentral Laky B, Janda M, Kondalsamy-Chennakesavan S, Cleghorn G, Obermair A (2010) Pretreatment malnutrition and quality of life—association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study. BMC Cancer 10:232CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Minig L, Biffi R, Zanagnolo V, Attanasio A, Beltrami C et al (2009) A. Early oral versus “traditional” postoperative feeding in gynecologic oncology patients undergoing intestinal resection: a randomized controlled trial. Ann Surg Oncol 16:1660–1668CrossRefPubMed Minig L, Biffi R, Zanagnolo V, Attanasio A, Beltrami C et al (2009) A. Early oral versus “traditional” postoperative feeding in gynecologic oncology patients undergoing intestinal resection: a randomized controlled trial. Ann Surg Oncol 16:1660–1668CrossRefPubMed
9.
Zurück zum Zitat Klein S, Simes J, Blackburn GL (1986) Total parenteral nutrition and cancer clinical trials. Cancer 58:1378–1386CrossRefPubMed Klein S, Simes J, Blackburn GL (1986) Total parenteral nutrition and cancer clinical trials. Cancer 58:1378–1386CrossRefPubMed
10.
Zurück zum Zitat Tixier H, Fraisse J, Chauffert B, Mayer F, Causeret S, Loustalot C et al (2010) Evaluation of pelvic posterior exenteration in the management of advanced-stage ovarian cancer. Arch Gynecol Obstet 281:505–510CrossRefPubMed Tixier H, Fraisse J, Chauffert B, Mayer F, Causeret S, Loustalot C et al (2010) Evaluation of pelvic posterior exenteration in the management of advanced-stage ovarian cancer. Arch Gynecol Obstet 281:505–510CrossRefPubMed
11.
Zurück zum Zitat Barber MD, Fearon KC, Delmore G, Loprinzi CL (1989) Should cancer patients with incurable disease receive parenteral or enteral nutritional support? Eur J Cancer 34:279–285CrossRef Barber MD, Fearon KC, Delmore G, Loprinzi CL (1989) Should cancer patients with incurable disease receive parenteral or enteral nutritional support? Eur J Cancer 34:279–285CrossRef
12.
Zurück zum Zitat Rettenmaier MA, Abaid LN, Brown JV 3rd, Mendivil AA, Micha JP et al (2014) The incidence of postprandial nausea and nutritional regression in gynecologic cancer patients following intestinal surgery: a retrospective cohort study. Int J Surg 12:783–787CrossRefPubMed Rettenmaier MA, Abaid LN, Brown JV 3rd, Mendivil AA, Micha JP et al (2014) The incidence of postprandial nausea and nutritional regression in gynecologic cancer patients following intestinal surgery: a retrospective cohort study. Int J Surg 12:783–787CrossRefPubMed
13.
Zurück zum Zitat Chi DS, Eisenhauer EL, Lang J, Huh J, Haddad L, Abu-Rustum NR et al (2006) What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 103:559–564CrossRefPubMed Chi DS, Eisenhauer EL, Lang J, Huh J, Haddad L, Abu-Rustum NR et al (2006) What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 103:559–564CrossRefPubMed
14.
Zurück zum Zitat Brard L, Weitzen S, Strubel-Lagan SL, Swamy N, Gordinier ME et al (2006) The effect of total parenteral nutrition on the survival of terminally ill ovarian cancer patients. Gynecol Oncol 103:176–180CrossRefPubMed Brard L, Weitzen S, Strubel-Lagan SL, Swamy N, Gordinier ME et al (2006) The effect of total parenteral nutrition on the survival of terminally ill ovarian cancer patients. Gynecol Oncol 103:176–180CrossRefPubMed
15.
Zurück zum Zitat Gerardi MA, Santillan A, Meisner B, Zahurak ML, Diaz Montes TP et al (2008) A clinical pathway for patients undergoing primary cytoreductive surgery with rectosigmoid colectomy for advanced ovarian and primary peritoneal cancers. Gynecol Oncol 108:282–286CrossRefPubMed Gerardi MA, Santillan A, Meisner B, Zahurak ML, Diaz Montes TP et al (2008) A clinical pathway for patients undergoing primary cytoreductive surgery with rectosigmoid colectomy for advanced ovarian and primary peritoneal cancers. Gynecol Oncol 108:282–286CrossRefPubMed
16.
Zurück zum Zitat National Institute of Health (2010) National Cancer Institute. CTCAE: common terminology criteria for adverse events, version 4.03. Washington National Institute of Health (2010) National Cancer Institute. CTCAE: common terminology criteria for adverse events, version 4.03. Washington
17.
Zurück zum Zitat Shamberger RC, Brennan MF, Goodgame JT Jr, Lowry SF, Maher MM et al (1984) A prospective, randomized study of adjuvant parenteral nutrition in the treatment of sarcomas: results of metabolic and survival studies. Surgery 96:1–13PubMed Shamberger RC, Brennan MF, Goodgame JT Jr, Lowry SF, Maher MM et al (1984) A prospective, randomized study of adjuvant parenteral nutrition in the treatment of sarcomas: results of metabolic and survival studies. Surgery 96:1–13PubMed
18.
Zurück zum Zitat American College of Physicians (1989) Parenteral nutrition in patients receiving cancer chemotherapy. American College of Physicians. Ann Intern Med 110:734–736CrossRef American College of Physicians (1989) Parenteral nutrition in patients receiving cancer chemotherapy. American College of Physicians. Ann Intern Med 110:734–736CrossRef
19.
Zurück zum Zitat Peter JV, Moran JL, Phillips-Hughes J (2005) A metaanalysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients. Crit Care Med 33:213–220CrossRefPubMed Peter JV, Moran JL, Phillips-Hughes J (2005) A metaanalysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients. Crit Care Med 33:213–220CrossRefPubMed
20.
Zurück zum Zitat Delgado-Rodríguez M, Medina-Cuadros M, Gómez-Ortega A, Martínez-Gallego G, Mariscal-Ortiz M et al (2002) Cholesterol and serum albumin levels as predictors of cross infection, death, and length of hospital stay. Arch Surg 137:805–812CrossRefPubMed Delgado-Rodríguez M, Medina-Cuadros M, Gómez-Ortega A, Martínez-Gallego G, Mariscal-Ortiz M et al (2002) Cholesterol and serum albumin levels as predictors of cross infection, death, and length of hospital stay. Arch Surg 137:805–812CrossRefPubMed
21.
Zurück zum Zitat Lohsiriwat V, Chinswangwatanakul V, Lohsiriwat S, Akaraviputh T, Boonnuch W et al (2007) Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients. Asia Pac J Clin Nutr 16:213–217PubMed Lohsiriwat V, Chinswangwatanakul V, Lohsiriwat S, Akaraviputh T, Boonnuch W et al (2007) Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients. Asia Pac J Clin Nutr 16:213–217PubMed
22.
Zurück zum Zitat Ryan AM, Hearty A, Prichard RS, Cunningham A, Rowley SP et al (2007) Association of hypoalbuminemia on the first postoperative day and complications following esophagectomy. J Gastrointest Surg 11:1355–1360CrossRefPubMed Ryan AM, Hearty A, Prichard RS, Cunningham A, Rowley SP et al (2007) Association of hypoalbuminemia on the first postoperative day and complications following esophagectomy. J Gastrointest Surg 11:1355–1360CrossRefPubMed
23.
Zurück zum Zitat Ataseven B, du Bois A, Reinthaller A, Traut A, Heitz F, Aust S et al (2015) Pre-operative serum albumin is associated with post-operative complication rate and overall survival in patients with epithelial ovarian cancer undergoing cytoreductive surgery. Gynecol Oncol 138:560–565CrossRefPubMed Ataseven B, du Bois A, Reinthaller A, Traut A, Heitz F, Aust S et al (2015) Pre-operative serum albumin is associated with post-operative complication rate and overall survival in patients with epithelial ovarian cancer undergoing cytoreductive surgery. Gynecol Oncol 138:560–565CrossRefPubMed
24.
Zurück zum Zitat Kathiresan AS, Brookfield KF, Schuman SI, Lucci JA 3rd (2010) Malnutrition as a predictor of poor postoperative outcomes in gynecologic cancer patients. Arch Gynecol Obstet 284:445–451CrossRefPubMed Kathiresan AS, Brookfield KF, Schuman SI, Lucci JA 3rd (2010) Malnutrition as a predictor of poor postoperative outcomes in gynecologic cancer patients. Arch Gynecol Obstet 284:445–451CrossRefPubMed
25.
Zurück zum Zitat Ionescu D, Tibrea C, Puia C (2013) Pre-operative hypoalbuminemia in colorectal cancer patients undergoing elective surgery—a major risk factor for postoperative outcome. Chirurgia 108:822–828PubMed Ionescu D, Tibrea C, Puia C (2013) Pre-operative hypoalbuminemia in colorectal cancer patients undergoing elective surgery—a major risk factor for postoperative outcome. Chirurgia 108:822–828PubMed
26.
Zurück zum Zitat Braga M, Ljungqvist O, Soeters P, Fearon K, Weimann A et al (2009) ESPEN guidelines on parenteral nutrition: surgery. Clin Nutr 28:378–386CrossRefPubMed Braga M, Ljungqvist O, Soeters P, Fearon K, Weimann A et al (2009) ESPEN guidelines on parenteral nutrition: surgery. Clin Nutr 28:378–386CrossRefPubMed
27.
Zurück zum Zitat Chambrier C, Sztark F, Société Francophone de nutrition clinique et métabolisme (SFNEP), Société française d’anesthésie et réanimation (SFAR) (2012) French clinical guidelines on perioperative nutrition. Update of the 1994 consensus conference on perioperative artificial nutrition for elective surgery in adults. J Visc Surg 149:e325–e336CrossRefPubMed Chambrier C, Sztark F, Société Francophone de nutrition clinique et métabolisme (SFNEP), Société française d’anesthésie et réanimation (SFAR) (2012) French clinical guidelines on perioperative nutrition. Update of the 1994 consensus conference on perioperative artificial nutrition for elective surgery in adults. J Visc Surg 149:e325–e336CrossRefPubMed
Metadaten
Titel
The impact of total parenteral nutrition on postoperative recovery in patients treated for advanced stage ovarian cancer
verfasst von
Alberto A. Mendivil
Mark A. Rettenmaier
Lisa N. Abaid
John V. Brown III
Kristina M. Mori
Bram H. Goldstein
Publikationsdatum
10.11.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2017
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4227-2

Weitere Artikel der Ausgabe 2/2017

Archives of Gynecology and Obstetrics 2/2017 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.