Effects of parenteral nutrition and hydration on survival in advanced cancer patients with malignant bowel obstruction: secondary analysis of a multicenter prospective cohort study

Sayaka Arakawa^{1

2}, Koji Amano^{3

4}, Shunsuke Oyamada⁵, Isseki Maeda⁶, Hiroto Ishiki¹, Tomofumi Miura⁷, Yutaka Hatano⁸, Akemi Shirado Naito⁹, Mamiko Sato¹⁰, Tetsuya Ito¹¹, Kazuhiro Kosugi⁷, Satoshi Miyake¹², Tatsuya Morita¹³, Masanori Mori¹³; East-Asian Collaborative Cross-Cultural Study To Elucidate the Dying Process (EASED) Investigators

Collaborators, Affiliations

Collaborators

East-Asian Collaborative Cross-Cultural Study To Elucidate the Dying Process (EASED) Investigators:
Satoshi Inoue, Naosuke Yokomichi, Kengo Imai, Hiroaki Tsukuura, Toshihiro Yamauchi, Yu Uneno, Akira Yoshioka, Shuji Hiramoto, Ayako Kikuchi, Tetsuo Hori, Yosuke Matsuda, Hiroyuki Kohara, Hiromi Funaki, Keiko Tanaka, Kozue Suzuki, Tina Kamei, Yukari Azuma, Teruaki Uno, Jiro Miyamoto, Hirofumi Katayama, Hideyuki Kashiwagi, Eri Matsumoto, Kiyofumi Oya, Takeya Yamaguchi, Tomonao Okamura, Hoshu Hashimoto, Shunsuke Kosugi, Nao Ikuta, Yaichiro Matsumoto, Takashi Ohmori, Takehiro Nakai, Takashi Ikee, Yuto Unoki, Kazuki Kitade, Shu Koito, Nanao Ishibashi, Masaya Ehara, Kosuke Kuwahara, Shohei Ueno, Shunsuke Nakashima, Yuta Ishiyama, Akihiro Sakashita, Ryo Matsunuma, Hana Takatsu, Takashi Yamaguchi, Satoko Ito, Toru Terabayashi, Jun Nakagawa, Tetsuya Yamagiwa, Akira Inoue, Takuhiro Yamaguchi, Mitsunori Miyashita, Saran Yoshida, Yusuke Hiratsuka, Keita Tagami, Hiroaki Watanabe, Takuya Odagiri, Masayuki Ikenaga, Keiji Shimizu, Akira Hayakawa, Rena Kamura, Takeru Okoshi, Tomohiro Nishi, Yasuhiro Shibata, Takayuki Hisanaga, Takahiro Higashibata, Ritsuko Yabuki, Shingo Hagiwara, Miho Shimokawa, Junko Nozato, Tetsuji Iriyama, Keisuke Kaneishi, Mika Baba, Yoshihisa Matsumoto, Ayumi Okizaki, Yuki Sumazaki Watanabe, Yuko Uehara, Eriko Satomi, Kaoru Nishijima, Junichi Shimoinaba, Ryoichi Nakahori, Takeshi Hirohashi, Jun Hamano, Natsuki Kawashima, Takashi Kawaguchi, Megumi Uchida, Ko Sato, Yoichi Matsuda, Satoru Tsuneto, Sayaka Maeda, Yoshiyuki Kizawa, Hiroyuki Otani

Affiliations

¹ Department of Palliative Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
² Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
³ Department of Palliative Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. kojiamano4813@gmail.com.
⁴ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute City, Aich, 480-1195, Japan. kojiamano4813@gmail.com.
⁵ Department of Biostatistics, JORTC Data Center, 2-54-6-302 Nishi-Nippori, Arakawa-ku, Tokyo, 116-0013, Japan.
⁶ Department of Palliative Care, Senri-Chuo Hospital, 1-4-3 Shinsenrihigashi-machi, Toyonaka City, Osaka, 560-0082, Japan.
⁷ Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa City, Chiba, 277-8577, Japan.
⁸ Department of Palliative Care, Daini Kyoritsu Hospital, 5-28 Sakaemachi, Kawanishi City, Hyogo, 666-0033, Japan.
⁹ Department of Palliative Care, Miyazaki Medical Association Hospital, 1173 Arita, Miyazaki City, Miyazaki, 880-2102, Japan.
¹⁰ Department of Palliative Care, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai City, Miyagi, 980-8575, Japan.
¹¹ Department of Palliative Care, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.
¹² Department of Internal Medicine, Palliative Care, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
¹³ Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu City, Shizuoka, 433-8558, Japan.

PMID: 34114097
DOI: 10.1007/s00520-021-06293-8

Multicenter Study

Effects of parenteral nutrition and hydration on survival in advanced cancer patients with malignant bowel obstruction: secondary analysis of a multicenter prospective cohort study

Sayaka Arakawa et al. Support Care Cancer. 2021 Dec.

. 2021 Dec;29(12):7541-7549.

doi: 10.1007/s00520-021-06293-8. Epub 2021 Jun 10.

Authors

Collaborators

East-Asian Collaborative Cross-Cultural Study To Elucidate the Dying Process (EASED) Investigators:
Satoshi Inoue, Naosuke Yokomichi, Kengo Imai, Hiroaki Tsukuura, Toshihiro Yamauchi, Yu Uneno, Akira Yoshioka, Shuji Hiramoto, Ayako Kikuchi, Tetsuo Hori, Yosuke Matsuda, Hiroyuki Kohara, Hiromi Funaki, Keiko Tanaka, Kozue Suzuki, Tina Kamei, Yukari Azuma, Teruaki Uno, Jiro Miyamoto, Hirofumi Katayama, Hideyuki Kashiwagi, Eri Matsumoto, Kiyofumi Oya, Takeya Yamaguchi, Tomonao Okamura, Hoshu Hashimoto, Shunsuke Kosugi, Nao Ikuta, Yaichiro Matsumoto, Takashi Ohmori, Takehiro Nakai, Takashi Ikee, Yuto Unoki, Kazuki Kitade, Shu Koito, Nanao Ishibashi, Masaya Ehara, Kosuke Kuwahara, Shohei Ueno, Shunsuke Nakashima, Yuta Ishiyama, Akihiro Sakashita, Ryo Matsunuma, Hana Takatsu, Takashi Yamaguchi, Satoko Ito, Toru Terabayashi, Jun Nakagawa, Tetsuya Yamagiwa, Akira Inoue, Takuhiro Yamaguchi, Mitsunori Miyashita, Saran Yoshida, Yusuke Hiratsuka, Keita Tagami, Hiroaki Watanabe, Takuya Odagiri, Masayuki Ikenaga, Keiji Shimizu, Akira Hayakawa, Rena Kamura, Takeru Okoshi, Tomohiro Nishi, Yasuhiro Shibata, Takayuki Hisanaga, Takahiro Higashibata, Ritsuko Yabuki, Shingo Hagiwara, Miho Shimokawa, Junko Nozato, Tetsuji Iriyama, Keisuke Kaneishi, Mika Baba, Yoshihisa Matsumoto, Ayumi Okizaki, Yuki Sumazaki Watanabe, Yuko Uehara, Eriko Satomi, Kaoru Nishijima, Junichi Shimoinaba, Ryoichi Nakahori, Takeshi Hirohashi, Jun Hamano, Natsuki Kawashima, Takashi Kawaguchi, Megumi Uchida, Ko Sato, Yoichi Matsuda, Satoru Tsuneto, Sayaka Maeda, Yoshiyuki Kizawa, Hiroyuki Otani

Affiliations

¹ Department of Palliative Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
² Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
³ Department of Palliative Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. kojiamano4813@gmail.com.
⁴ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute City, Aich, 480-1195, Japan. kojiamano4813@gmail.com.
⁵ Department of Biostatistics, JORTC Data Center, 2-54-6-302 Nishi-Nippori, Arakawa-ku, Tokyo, 116-0013, Japan.
⁶ Department of Palliative Care, Senri-Chuo Hospital, 1-4-3 Shinsenrihigashi-machi, Toyonaka City, Osaka, 560-0082, Japan.
⁷ Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa City, Chiba, 277-8577, Japan.
⁸ Department of Palliative Care, Daini Kyoritsu Hospital, 5-28 Sakaemachi, Kawanishi City, Hyogo, 666-0033, Japan.
⁹ Department of Palliative Care, Miyazaki Medical Association Hospital, 1173 Arita, Miyazaki City, Miyazaki, 880-2102, Japan.
¹⁰ Department of Palliative Care, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai City, Miyagi, 980-8575, Japan.
¹¹ Department of Palliative Care, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.
¹² Department of Internal Medicine, Palliative Care, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
¹³ Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu City, Shizuoka, 433-8558, Japan.

PMID: 34114097
DOI: 10.1007/s00520-021-06293-8

Abstract

Purpose: The benefits of parenteral nutrition and hydration (PNH) in patients with advanced cancer remain unknown. Therefore, we conducted a prospective multicenter cohort study to assess the effects of PNH on survival in patients with malignant bowel obstruction (MBO).

Methods: The present study was a secondary analysis. Data on primary nutritional administration routes during the first week of admission to palliative care units, i.e., parenteral nutrition and parenteral hydration, were obtained. Data on the averaged calorie sufficiency rate/total calorie intake (75% ≤ or 750 kcal/day ≤ , 50-75% or 500-750 kcal/day, 25-50% or 250-500 kcal/day, and < 25% or < 250 kcal/day) were also obtained. Participants with MBO were included and divided into two groups: PNH-high (25% ≤ or 250 kcal/day ≤) and PNH-low (< 25% or < 250 kcal/day). We performed time-to-event analyses using the Kaplan-Meier method, log-rank test, and univariate and multivariate Cox regression analyses.

Results: Patients were divided into the PNH-high (n = 68) and PNH-low (n = 76) groups. A significant difference was observed in survival rates between the two groups (log-rank P < 0.001). Median survival times were 35.5 (95% CI 27-44) and 17.5 (95% CI 13-21) days, respectively. In the multivariate-adjusted model, a significantly lower risk of mortality was observed in Cox's proportional hazard model in the PNH-high group (HR 0.55 (95% CI 0.36-0.83), P = 0.005) than in the PNH-low group.

Conclusion: The present results indicated the beneficial effects of PNH for prolonging survival in advanced cancer patients with MBO in palliative care units.

Keywords: Advanced cancer; Cachexia; Malignant bowel obstruction; Nutritional support; Palliative care; Parenteral nutrition.

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References

1. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F et al (2017) ESPEN guidelines on nutrition in cancer patients. Clin Nutr 36(1):11–48 - DOI
1. Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP et al (2017) ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr 36(5):1187–1196 - DOI
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1. Good P, Richard R, Syrmis W, Jenkins-Marsh S, Stephens J (2014) Medically assisted nutrition for adult palliative care patients (Review). Cochrane Database Syst Rev (4):CD006274

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Effects of parenteral nutrition and hydration on survival in advanced cancer patients with malignant bowel obstruction: secondary analysis of a multicenter prospective cohort study

Collaborators

Affiliations

Effects of parenteral nutrition and hydration on survival in advanced cancer patients with malignant bowel obstruction: secondary analysis of a multicenter prospective cohort study

Authors

Collaborators

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical