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Perioperative immunonutrition in well-nourished patients undergoing surgery for head and neck cancer: evaluation of inflammatory and immunologic outcomes

Perioperative immunonutrition in well-nourished patients undergoing surgery for head and neck cancer: evaluation of inflammatory and immunologic outcomes
Perioperative immunonutrition in well-nourished patients undergoing surgery for head and neck cancer: evaluation of inflammatory and immunologic outcomes
Limited work is available on the benefits of nutritional support enriched with arginine and n-3 fatty acids in surgical patients with head and neck cancer, particularly if well-nourished. We conducted a pilot study in these patients to examine effects on inflammatory markers and clinical outcome. Patients scheduled for radical resection of the oral cavity were randomised to 5 day preoperative and 5 day postoperative Impact® (IMN, n = 4), or no preoperative supplementary nutrition and Isosource® postoperatively (STD, n = 4). Plasma fatty acids, C-reactive protein (CRP), tumour necrosis factor (TNF)-?, interleukin (IL)-6 and IL-10 were measured at baseline, day of surgery and on postoperative days (POD) 2, 4 and 10. Postoperative complications were recorded. The (eicosapentaenoic acid plus docosahexaenoic acid) to arachidonic acid ratio was significantly higher in IMN patients on POD 2, 4 and 10 (P < 0.01). While not statistically significant, CRP, TNF-?, and IL-6 concentrations were higher in the STD group on POD2 while IL-10 was lower. Median length of stay was 10 (range 10–43) days in the IMN group and 21.5 (7–24) days in the STD group. Five complications were seen in the STD group and two in the IMN group. The results support the need for a larger trial focusing on clinical outcome
1186-1199
Turnock, Amy
20126709-9620-41d1-be4d-0681069df989
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
West, Annette L.
c1923242-802f-4331-b743-31de45d3883c
Izzard, Mark
d63a42e2-1669-472a-beb2-e0069c8bbbc4
Morton, Randall P.
29fa68a4-4c73-45d8-8de6-16317c0e0bb9
Plank, Lindsay D.
d9003292-e741-47a7-9e93-0d6fddc34e65
Turnock, Amy
20126709-9620-41d1-be4d-0681069df989
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
West, Annette L.
c1923242-802f-4331-b743-31de45d3883c
Izzard, Mark
d63a42e2-1669-472a-beb2-e0069c8bbbc4
Morton, Randall P.
29fa68a4-4c73-45d8-8de6-16317c0e0bb9
Plank, Lindsay D.
d9003292-e741-47a7-9e93-0d6fddc34e65

Turnock, Amy, Calder, Philip C., West, Annette L., Izzard, Mark, Morton, Randall P. and Plank, Lindsay D. (2013) Perioperative immunonutrition in well-nourished patients undergoing surgery for head and neck cancer: evaluation of inflammatory and immunologic outcomes. Nutrients, 5 (4), 1186-1199. (doi:10.3390/nu5041186). (PMID:23571650)

Record type: Article

Abstract

Limited work is available on the benefits of nutritional support enriched with arginine and n-3 fatty acids in surgical patients with head and neck cancer, particularly if well-nourished. We conducted a pilot study in these patients to examine effects on inflammatory markers and clinical outcome. Patients scheduled for radical resection of the oral cavity were randomised to 5 day preoperative and 5 day postoperative Impact® (IMN, n = 4), or no preoperative supplementary nutrition and Isosource® postoperatively (STD, n = 4). Plasma fatty acids, C-reactive protein (CRP), tumour necrosis factor (TNF)-?, interleukin (IL)-6 and IL-10 were measured at baseline, day of surgery and on postoperative days (POD) 2, 4 and 10. Postoperative complications were recorded. The (eicosapentaenoic acid plus docosahexaenoic acid) to arachidonic acid ratio was significantly higher in IMN patients on POD 2, 4 and 10 (P < 0.01). While not statistically significant, CRP, TNF-?, and IL-6 concentrations were higher in the STD group on POD2 while IL-10 was lower. Median length of stay was 10 (range 10–43) days in the IMN group and 21.5 (7–24) days in the STD group. Five complications were seen in the STD group and two in the IMN group. The results support the need for a larger trial focusing on clinical outcome

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Published date: 9 April 2013
Organisations: Human Development & Health

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Local EPrints ID: 352112
URI: http://eprints.soton.ac.uk/id/eprint/352112
PURE UUID: 7807eed1-4415-4c21-830a-a4493ca01f9f
ORCID for Philip C. Calder: ORCID iD orcid.org/0000-0002-6038-710X
ORCID for Annette L. West: ORCID iD orcid.org/0000-0002-3331-0684

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Date deposited: 02 May 2013 10:29
Last modified: 23 Jul 2022 01:54

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Contributors

Author: Amy Turnock
Author: Annette L. West ORCID iD
Author: Mark Izzard
Author: Randall P. Morton
Author: Lindsay D. Plank

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