Immunonutrition in major oncologic head and neck surgery: Analysis of complications, plasmatic equilibrium, and costs. Issue 2 (9th December 2022)

• Record Type: Journal Article
• Authors: Ascoli, Alessandro; Missale, Francesco; Giordano, Giorgio‐Gregory; Vallin, Alberto; Gradaschi, Raffaella; Guiddo, Erica; Schenone, Guido; Sukkar, Samir Giuseppe; Copello, Francesco; Parrinello, Giampiero; Iandelli, Andrea; Peretti, Giorgio; Marchi, Filippo
• Is Part Of: Head & neck. Volume 45:Issue 2(2023)
• Page Start: 449
• Page End: 463
• Publication Date: 2022-12-09
• Subjects: albumin -- complications -- cost analysis -- head and neck cancer -- immunonutrition -- surgery; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.27270
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Malnutrition, in patients with solid tumors, is associated with a worse clinical outcome and about 40% of patients affected by head and neck cancers (HNC) are malnourished at the time of cancer diagnosis. We investigated the potential benefit of a standardized immunonutritional protocol (INP) to patients with HNC receiving major ablative surgery. Methods: An observational study was conducted enrolling 199 patients: 50 treated with the INP and 149 with standard enteral nutrition. Complication rates, need for medications, and costs were considered as outcomes. Results: INP played a protective role in development of major surgical complications (OR 0.23, p = 0.023), albumin administration (RR 0.38, p = 0.018), and antibiotic duration ( p < 0.001) and is cost‐effective in patients with moderate or severe malnutrition (−6083€ and −11 988€, p < 0.05). Conclusions: Our study supports the utility of INP, and accurate nutritional screening can help to identify malnourished patients who would receive the most benefits from this protocol.