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Nutritional support after hospital discharge reduces long-term mortality in patients after gastric cancer surgery: Secondary analysis of a prospective randomized trial

Shan-Jun Tan, Q. Xi, Zhige Zhang, Mingyue Yan, Q. Meng, Q. Zhuang, Guo-Hao Wu

Nutrition (Burbank, Los Angeles County, Calif.), 2024

321 participants · 9 citations

Abstract

BACKGROUND AND AIMS

Nutritional support after hospital discharge was found to enhance the nutritional condition of patients after cancer surgery. However, the effect of such support on long-term clinical outcomes is controversial. We thus investigated the effect of nutritional support after hospital discharge on long-term clinical outcomes in patients after gastric cancer surgery.

METHODS

This was a secondary analysis on individuals at nutritional risk who underwent gastric cancer surgery and were included in a randomized controlled trial. The intervention group received oral nutritional supplements combined with dietary advice, and the control group received dietary advice alone. The long-term mortality (primary outcome) and other clinical outcomes were compared between the groups.

RESULTS

In total, 321 patients were included in this analysis, with a median follow-up duration of 60.5 months. According to the Nutritional Risk Screening 2002 (NRS 2002), the presence of nutritional risk was found to be a significant predictor of death. This association remained independent even after adjusting for age, sex, comorbidity, and American Joint Committee on Cancer stage. The adjusted hazard ratio for mortality increased by 1.30 (95% confidence interval [CI] 1.05-1.60, P = 0.016) for each additional point rise in NRS. During the follow-up, a total of 64 individuals (39.5%) in the intervention group and 81 patients (50.9%) in the control group died. Consequently, the adjusted hazard…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 321 participants or records.

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