Immunonutrition in surgical cancer patients: update and state of the art

Authors

  • Carlos Reyes-Torres ITESM
  • Ana Daniela Delgado-Salgado
  • Sergio Díaz-Paredes
  • Eva Lucía Willars-Inman

DOI:

https://doi.org/10.35454/rncm.v5n4.430

Keywords:

Cáncer, Desnutrición, Cirugía, Inmunonutrición

Abstract

 

 Malnutrition in cancer patients undergoing a surgical procedure is one of the main nutritional factors associated with adverse clinical outcomes such as increased risk of infections, increased risk of fistula formation, increased length of stay, as well as an increased mortality risk. Immunonutrition (IMN) is defined as the use of nutrients at doses much higher than daily requirements in order to modulate the response of the host immune system, the inflammatory process, and improve the nutritional status of surgical patients. It is important to describe the current status of the use of IMN in cancer patients undergoing surgery in order to apply nutritional therapy appropriately to reduce adverse clinical outcomes and improve prognosis. The aim of this review is to learn about the current state of the art of IMN in surgical oncology patients and offer recommendations for clinical practice based on the best scientific evidence currently available.

Downloads

Download data is not yet available.

References

Klek S, Szybinski P, Szczepanek K. Perioperative immunonutrition in surgical cancer patients: a summary of a decade of research. World J Surg. 2014;38(4):803-12. doi: 10.1007/s00268-013-2323-z

Mariette C. Immunonutrition. J Visc Surg. 2015;152(1):S14-7. doi: 10.1016/S1878-7886(15)30005-9

Mizock BA. Immunonutrition and critical illness: an update. Nutrition. 2010;26(7-8):701-7. doi: 10.1016/j.nut.2009.11.010

Castillo-Martinez L, Castro-Eguiluz D, Copca-Mendoza ET, Perez-Camargo DA, Reyes-Torres CA, Avila EAD, et al. Nutritional assessment tools for the identification of malnutrition and nutritional risk associated with cancer treatment. Rev Invest Clin. 2018;70(3):121-5. doi: 10.24875/RIC.18002524

Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, et al. ESPEN practical guideline: clinical nutrition in cancer. Clin Nutr. 2021;40(5):2898-913. doi: 10.1016/j.clnu.2021.02.005

Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36(5):1187-96. doi: 10.1016/j.clnu.2017.06.017

Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-50. doi: 10.1016/j.clnu.2017.02.013

Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery a review. JAMA Surg. 2017;152(3):292-8. doi: 10.1001/jamasurg.2016.4952

Adiamah A, Skořepa P, Weimann A, Lobo DN. The impact of preoperative immune modulating nutrition on outcomes in patients undergoing surgery for gastrointestinal cancer: a systematic review and meta-analysis. Ann Surg. 2019;270(2):247-56. doi: 10.1097/SLA.0000000000003256

McCarthy MS, Martindale RG. Immunonutrition in critical illness: what is the role? Nutr Clin Pract. 2018;33(3):348-58. doi: 10.1002/ncp.10102

Fuchs-Tarlovsky V. Role of antioxidants in cancer therapy. Nutrition. 2013;29(1):15-21. doi: 10.1016/j.nut.2012.02.014

Suchner U, Kuhn KS, Fürst P. The scientific basis of immunonutrition. Proc Nutr Soc. 2000;59(4):553-63. doi: 10.1017/s0029665100000793

Heyland D, Muscedere J, Wischmeyer PE, Cook D, Jones G, Albert M, et al. A randomized trial of glutamine and antioxidants in critically ill patients. N Engl J Med. 2013;368(16):1489-97. doi: 10.1056/NEJMoa1212722. Erratum in: N Engl J Med. 2013;368(19):1853

De-Souza DA, Greene LJ. Intestinal permeability and systemic infections in critically ill patients: effect of glutamine. Crit Care Med. 2005;33(5):1125-35. doi: 10.1097/01.ccm.0000162680.52397.97

Heyland DK, Dhaliwal R. Role of glutamine supplementation in critical illness given the results of the REDOXS study. J Parenter Enteral Nutr. 2013;37(4):442-3. doi: 10.1177/0148607113488421

Yang T, Yan X, Cao Y, Bao T, Li G, Gu S, et al. Meta-analysis of glutamine on immune function and post-operative complications of patients with colorectal cancer. Front Nutr. 2021;8:765809. doi: 10.3389/fnut.2021.765809

Tsuei BJ, Bernard AC, Shane MD, Shirley LA, Maley ME, Boulanger BR, et al. Surgery induces human mononuclear cell arginase I expression. J Trauma. 2001;51(3):497-502. doi: 10.1097/00005373-200109000-00012

Barbul A, Rettura G, Levenson SM, See E. Wound healing and thymotropic effects of arginine: a pituitary mechanism of action. Am J Clin Nutr. 1983;37:786-94. doi: 10.1093/ajcn/37.5.786

Patel JJ, Miller KR, Rosenthal C, Rosenthal MD. when is it appropriate to use arginine in critical illness? Nutr Clin Pract. 2016;31(4):438-44. doi: 10.1177/0884533616652576

D’Ignazio A, Kabata P, Ambrosio MR, Polom K, Marano L, Spagnoli L, et al. Preoperative oral immunonutrition in gastrointestinal surgical patients: how the tumour microenvironment can be modified. Clin Nutr ESPEN. 2020;38:153-9. doi: 10.1016/j.clnesp.2020.05.012

Martin RCG, Agle S, Schlegel M, Hayat T, Scoggins CR, McMasters KM, et al. Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE). Eur J Surg Oncol. 2017;43(4):772-9. doi: 10.1016/j.ejso.2017.01.002

Marik PE, Zaloga GP. Immunonutrition in high-risk surgical patients: a systematic review and analysis of the literature. JPEN J Parenter Enteral Nutr. 2010;34(4):378-86. doi: 10.1177/0148607110362692

Ginguay A, De Bandt JP, Cynober L. Indications and contraindications for infusing specific amino acids (leucine, glutamine, arginine, citrulline, and taurine) in critical illness. Curr Opin Clin Nutr Metab Care. 2016;19(2):161-9. doi: 10.1097/MCO.0000000000000255

Romo-Romo A, Reyes-Torres CA, Janka-Zires M, Almeda-Valdés P. El rol de la nutrición en la enfermedad por coronavirus 2019 (COVID-19). Rev Mex Endocrinol Metab Nutr. 2020;7:132-43. doi: 10.24875/RME.20000060

Calder PC, Adolph M, Deutz NE, Grau T, Innes JK, Klek S, et al. Lipids in the intensive care unit: recommendations from the ESPEN Expert Group. Clin Nutr. 2018;37(1):1-18. doi: 10.1016/j.clnu.2017.08.032

Calder PC. Very long-chain n-3 fatty acids and human health: fact, fiction and the future. Proc Nutr Soc. 2018;77(1):52-72. doi: 10.1017/S0029665117003950

Fenton JI, Hord NG, Ghosh S, Gurzell EA. Immunomodulation by dietary long chain omega-3 fatty acids and the potential for adverse health outcomes. Prostaglandins Leukot Essent Fatty Acids. 2013;89(6):379-90. doi: 10.1016/j.plefa.2013.09.011

Mauskopf JA, Candrilli SD, Chevrou-Séverac H, Ochoa JB. Immunonutrition for patients undergoing elective surgery for gastrointestinal cancer: impact on hospital costs. World J Surg Oncol. 2012;10:136. doi: 10.1186/1477-7819-10-136

Bharadwaj S, Trivax B, Tandon P, Alkam B, Hanouneh I, Steiger E. Should perioperative immunonutrition for elective surgery be the current standard of care? Gastroenterol Rep (Oxf). 2016;4(2):87-95. doi: 10.1093/gastro/gow008

Zhang Y, Gu Y, Guo T, Li Y, Cai H. Perioperative immunonutrition for gastrointestinal cancer: a systematic review of randomized controlled trials. Surg Oncol. 2012;21(2):e87-95. doi: 10.1016/j.suronc.2012.01.002

Mauskopf JA, Candrilli SD, Chevrou-Séverac H, Ochoa JB. Immunonutrition for patients undergoing elective surgery for gastrointestinal cancer: impact on hospital costs. World J Surg Oncol. 2012;10:136. doi: 10.1186/1477-7819-10-136

Jabłońska B, Mrowiec S. The role of immunonutrition in patients undergoing pancreaticoduodenectomy. Nutrients. 2020;12(9):2547. doi: 10.3390/nu12092547

Bermúdez C, Sanabria Á, Ayala J, Becerra A, Chona M, Colpas L, et al. Inmunonutrición perioperatoria. Consenso de la Asociación Colombiana de Nutrición Clínica. Rev Nutr Clín Metabol. 2019;2(1):15-28. doi: 10.35454/rncm.v2n1.055

Published

2022-12-08

How to Cite

Reyes-Torres, C., Delgado-Salgado, A. D. ., Díaz-Paredes, S., & Willars-Inman, E. L. (2022). Immunonutrition in surgical cancer patients: update and state of the art. Journal Clinical Nutrition and Metabolism, 5(4), 65–71. https://doi.org/10.35454/rncm.v5n4.430