ESPEN 2012 - Late breaking abstract submission
Topic: Late Breaking Abstract
Abs n°:ESPEN12-1898
Abs Title: REDUCED INFECTIONS WITH PERIOPERATIVE IMMUNONUTRITION IN HEAD AND NECK CANCER: A MULTICENTER, PROSPECTIVE, RANDOMIZED, DOUBLE BLIND STUDY
M.-N. Falewee 1,*A. SCHILF 2E. BOUSSLERS 3C. CARTIER 4P. BACHMANN 5M. PRESSOIR 6C. MICHEL 1M. ETTAICHE 1
1Centre Antoine Lacassagne, Nice, 2IGR, VILLEJUIF, 3OSCAR LAMBRET, LILLE, 4CHU , Montpellier, 5Centre Léon Bérard, Lyon, 6CLCC, Toulouse, France
Rationale: Cancer surgery of the upper aero-digestive tract is burdened with 20 to 60% of complications favored by malnutrition, alcoholism and immunosuppression due to cancer. The aim of our study was to investigate whether preoperative or perioperative immunonutrition in head and neck cancer patients could reduce postoperative infectious complications and surgical-site infections (SSI).
Methods: This was a multicenter, prospective, randomized, double-blind study. Patients with oropharyngeal and pharyngolaryngeal lesions were randomly allocated to three groups: a) perioperative isocaloric, isonitrogenous formula of Impactâ without immunonutriments named “reference diet” (group A, control); b) preoperative Impactâ and “reference diet” postoperatively (group B); c) Impactâ perioperatively (group C). Products were available in oral and enteral formula and were given 7 days before surgery and during 7 (minimum) to 15 days (maximum) after surgery. The primary endpoint was the incidence of global infectious complications. The secondary endpoint was the incidence of SSI.
Results: Of 312 randomized patients, 205 were evaluable for the analysis (64 in group A, 68 in group B, 73 in group C). There was no significant difference in global infectious complications (GIC) and SSI (p=0.3 A vs C). However, in the population taking at least 75% of the theorical intake from surgery to day 10 (n=51), the comparison between the groups A and C demonstrates a significant difference in GIC (OR=4.0, p=0.05, Fishers Exact test), SSI (OR=5.5, p=0.04, Fishers Exact test) and also in the median length of postoperative stay (18 vs 25 days, p=0.05, Wilcoxon test).
Conclusion: Perioperative immunonutrition significantly reduced GIC and SSI in head and neck cancer patients undergoing surgery only if theorical intake is reached.
Reference(s): No
Disclosure of Interest: None Declared
Keywords: immunonutrition, head and neck, infections