Koretz and colleagues performed a systematic review that showed parenteral nutrition did not improve mortality, increased rates of infectious complications by 16% and had an approximately 40% increase in total complications.4

Baldwin and colleagues evaluated enteral nutrition in patients with cancer and reported no mortality benefit but some improvement in weight and quality of life.5 It is important to note that both of these studies were reviews and therefore included a multitude of different clinical trials.

Although some studies may be more in support of enteral or parenteral nutrition in patients with cancer, the ideal patient and clinical scenario to utilize them is yet to be determined.


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Patients that could benefit the most from nutritional support include those that have a malignancy that is potentially curable or those who may have a significant chance of disease-free survival.

Patients who have end-stage cancer may not be the best candidates for nutritional support as many of the clinical studies conducted have shown limited improvement in quality of life and no reduction in mortality.6

Therefore, many nutrition and oncology societies advise against artificial nutrition in patients with advanced cancer.

References

  1. Nitenberg G, Raynard B. Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol. 2000;34(3):137-168.
  2. Senesse P, Assenat E, Schneider S, et al. Nutritional support during oncologic treatment of patients with gastrointestinal cancer: who could benefit? Cancer Treat Rev. 2008;34(6):568-575.
  3. Ryu SW, Kim IH. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol. 2010;16(26):3310-3317.
  4. Koretz RL, Lipman TO, Klein S; American Gastroenterological Association.. AGA technical review on parenteral nutrition. Gastroenterology. 2001;121(4):970-1001.
  5. Baldwin C, Spiro A, Ahern R, Emery PW. Oral nutritional interventions in malnourished patients with cancer: a systematic review and meta-analysis. J Natl Cancer Inst. 2012;104(5):371-385.
  6. Bozzetti F, Arends J, Lundholm K, et al. ESPEN Guidelines on Parenteral Nutrition: non-surgical oncology. Clin Nutr. 2009;28(4):445-454.