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Healthcare
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Artificial Nutrition in Cancer Patients
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Artificial Nutrition in Cancer Patients

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (30 October 2020) | Viewed by 20447

Special Issue Editor

Dr. Paolo Cotogni

E-Mail Website1 Website2
Guest Editor
Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital and University of Turin, 10126 Turin, Italy
Interests: nutrition support in cancer and critically ill patients; vascular access devices; palliative care (screening and symptom control) in advanced cancer patients and seriously ill patients with end-stage organ failure; healthcare service management (in-hospital admission and management; safe discharge)
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Many studies assessing outcomes in cancer patients undergoing anticancer treatments (surgery, chemo- and radiation therapy) have clearly shown that lean body mass loss is an independent risk factor for complications, dose-limiting toxicity, hospitalization, and survival. The introduction of artificial nutrition is often appropriate in the course of cancer disease and may be provided in addition to anticancer treatments intended to prolong life. Moreover, for patients with chronic insufficient dietary intake and/or uncontrollable malabsorption, home artificial nutrition (either enteral or parenteral) should be used, when suitable. However, little is known on whether artificial nutrition improves the survival of cancer patients with advanced disease, beyond its role in ameliorating anthropometric measures and domains of quality of life. Finally, the use of artificial nutrition in incurable patients who are unable to eat, mainly due to malignant intestinal obstructions, is extremely controversial.

This Special Issue seeks papers (original clinical studies and reviews) related to cancer patients receiving artificial nutrition and the following suggested topics. This invitation is addressed to all healthcare providers (i.e., oncologists, clinical nutrition experts, internal medicine physicians, surgeons, palliative care physicians, dieticians, nurses, pharmacists, and psychologists) involved in the care of cancer patients throughout the course of disease.

Suggested topics:

  • Artificial nutrition in palliative care patients: ethical dilemmas;
  • Artificial nutrition in the treatment of weight loss and cachexia;
  • Choice of nutrients;
  • Comparing enteral with parenteral nutrition;
  • Complications of artificial nutrition;
  • Enteral nutrition;
  • Healthcare costs for artificial nutrition;
  • Healthcare service organization for home artificial nutrition;
  • Home artificial nutrition;
  • Impact of artificial nutrition on postoperative complications;
  • Impact of artificial nutrition on quality of life;
  • Impact of artificial nutrition on survival;
  • Monitoring of artificial nutrition;
  • Parenteral nutrition;
  • Prevalence of artificial nutrition in the world;
  • Role of artificial nutrition in patients receiving chemoradiotherapy;
  • Supplemental versus total artificial nutrition;
  • Timing for the prescription of artificial nutrition.

Dr. Paolo Cotogni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • artificial nutrition
  • cancer
  • malnutrition
  • anticancer treatments
  • quality of life
  • survival
  • home care
  • palliative care
  • ethics
  • management
  • nutrients

Published Papers (5 papers)

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Research

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11 pages, 1354 KiB  
Article
The Advantages of Clinical Nutrition Use in Oncologic Patients in Italy: Real World Insights
by Paolo Pedrazzoli, Riccardo Caccialanza, Paolo Cotogni, Luca Degli Esposti, Valentina Perrone, Diego Sangiorgi, Francesco Di Costanzo, Cecilia Gavazzi, Armando Santoro and Carmine Pinto
Healthcare 2020, 8(2), 125; https://doi.org/10.3390/healthcare8020125 - 06 May 2020
Cited by 10 | Viewed by 4125
Abstract
This retrospective observational study aimed to provide insights on the use of clinical nutrition (CN) (enteral and parenteral feeding) and outcomes in an Italian real-world setting. The data source comes from administrative databases of 10 Italian Local Health Units. Patients diagnosed with malignant [...] Read more.
This retrospective observational study aimed to provide insights on the use of clinical nutrition (CN) (enteral and parenteral feeding) and outcomes in an Italian real-world setting. The data source comes from administrative databases of 10 Italian Local Health Units. Patients diagnosed with malignant neoplasms from 1 January 2010 to 31 December 2015 were included. Metastasis presence was ascertained by discharge diagnosis in the hospitalization database. CN was identified by specific codes from pharmaceutical and hospitalization databases. Two cohorts were created—one for metastatic patients (N = 53,042), and one for non-metastatic patients (N = 4379) receiving CN. Two survival analyses were set for the cohort of metastatic patients—one included patients receiving CN and the second included malnourished patients. Our findings show that (1) administration of CN is associated with positive survival outcomes in metastatic patients with gastrointestinal, respiratory, and genitourinary cancer; (2) CN in malnourished metastatic patients with gastrointestinal and genitourinary cancer was associated with significant improvement in survival; (3) early administration of CN was associated with improvement in survival in non-metastatic patients with gastrointestinal cancer (HR 95%CI: 0.5 (0.4–0.6), p-value < 0.05). This study highlights the need to improve the assessment of nutritional status in oncologic patients and suggests a potential survival benefit of CN treatment in metastatic disease. Full article
(This article belongs to the Special Issue Artificial Nutrition in Cancer Patients)
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Review

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12 pages, 685 KiB  
Review
Impact of Artificial Nutrition on Postoperative Complications
by Sergio Sandrucci, Paolo Cotogni and Beatrice De Zolt Ponte
Healthcare 2020, 8(4), 559; https://doi.org/10.3390/healthcare8040559 - 14 Dec 2020
Cited by 8 | Viewed by 2775
Abstract
Malnutrition is common in surgical cancer patients and it is widely accepted that it can adversely affect their postoperative outcome. Assessing the nutritional status of every patient, in particular care of elderly and cancer patients, is a crucial feature of the therapeutic pathway [...] Read more.
Malnutrition is common in surgical cancer patients and it is widely accepted that it can adversely affect their postoperative outcome. Assessing the nutritional status of every patient, in particular care of elderly and cancer patients, is a crucial feature of the therapeutic pathway in order to optimize every strategy. Evidence exists that the advantages of perioperative nutrition are more significant in malnourished patients submitted to major surgery. For patients recognized as malnourished, preoperative nutrition therapies are indicated; the choice between parenteral and enteral nutrition is still controversial in perioperative malnourished surgical cancer patients, although enteral nutrition seems to have the best risk–benefit ratio. Early oral nutrition after surgery is advisable, when feasible, and should be administered in all the patients undergoing elective major surgery, if compliant. In patients with high risk for postoperative infections, perioperative immunonutrition has been proved in some ways to be effective, even if operations including those for cancer have to be delayed. Full article
(This article belongs to the Special Issue Artificial Nutrition in Cancer Patients)
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17 pages, 825 KiB  
Review
Opportunities for Quality Improvement Programs (QIPs) in the Nutrition Support of Patients with Cancer
by Mary Beth Arensberg, Julie Richards, Jyoti Benjamin, Kirk Kerr and Refaat Hegazi
Healthcare 2020, 8(3), 227; https://doi.org/10.3390/healthcare8030227 - 24 Jul 2020
Cited by 12 | Viewed by 5017
Abstract
Malnutrition in patients with cancer is a ubiquitous but neglected problem that can reduce patient survival/quality of life and increase treatment interruptions, readmission rates, and healthcare costs. Malnutrition interventions, including nutrition support through dietary counseling, diet fortification, oral nutrition supplements (ONS), and enteral [...] Read more.
Malnutrition in patients with cancer is a ubiquitous but neglected problem that can reduce patient survival/quality of life and increase treatment interruptions, readmission rates, and healthcare costs. Malnutrition interventions, including nutrition support through dietary counseling, diet fortification, oral nutrition supplements (ONS), and enteral and parenteral nutrition can help improve health outcomes. However, nutritional care standards and interventions for cancer are ambiguous and inconsistently applied. The lack of systematic malnutrition screening and intervention in ambulatory cancer care has especially significant consequences and thus the nutrition support of patients with cancer represents an area for quality improvement. United States healthcare payment models such as the Oncology Care Model are linked to quality of care and health outcomes. Quality improvement programs (QIPs) can advance patient-centered care, perfect care processes, and help healthcare professionals meet their quality measure performance goals. Malnutrition QIPs like the Malnutrition Quality Improvement Initiative (MQii) have been shown to be effective in identifying and treating malnutrition. However, little is known about or has been reported on nutrition or malnutrition-focused QIPs in cancer care. This paper provides information to support translational research on quality improvement and outlines the gaps and potential opportunities for QIPs in the nutrition support of patients with cancer. Full article
(This article belongs to the Special Issue Artificial Nutrition in Cancer Patients)
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14 pages, 1335 KiB  
Review
Monitoring Response to Home Parenteral Nutrition in Adult Cancer Patients
by Paolo Cotogni, Riccardo Caccialanza, Paolo Pedrazzoli, Federico Bozzetti and Antonella De Francesco
Healthcare 2020, 8(2), 183; https://doi.org/10.3390/healthcare8020183 - 23 Jun 2020
Cited by 9 | Viewed by 3689
Abstract
Current guidelines recommend home parenteral nutrition (HPN) for cancer patients with chronic deficiencies of dietary intake or absorption when enteral nutrition is not adequate or feasible in suitable patients. HPN has been shown to slow down progressive weight loss and improve nutritional status, [...] Read more.
Current guidelines recommend home parenteral nutrition (HPN) for cancer patients with chronic deficiencies of dietary intake or absorption when enteral nutrition is not adequate or feasible in suitable patients. HPN has been shown to slow down progressive weight loss and improve nutritional status, but limited information is available on the monitoring practice of cancer patients on HPN. Clinical management of these patients based only on nutritional status is incomplete. Moreover, some commonly used clinical parameters to monitor patients (weight loss, body weight, body mass index, and oral food intake) do not accurately reflect patient’s body composition, while bioelectrical impedance analysis (BIA) is a validated tool to properly assess nutritional status on a regular basis. Therefore, patient’s monitoring should rely on other affordable indicators such as Karnofsky Performance Status (KPS) and modified Glasgow Prognostic Score (mGPS) to also assess patient’s functional status and prognosis. Finally, catheter-related complications and quality of life represent crucial issues to be monitored over time. The purpose of this narrative review is to describe the role and relevance of monitoring cancer patients on HPN, regardless of whether they are receiving anticancer treatments. These practical tips may be clinically useful to better guide healthcare providers in the nutritional care of these patients. Full article
(This article belongs to the Special Issue Artificial Nutrition in Cancer Patients)
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8 pages, 218 KiB  
Review
Nutritional Issues in Head and Neck Cancer Patients
by Federico Bozzetti and Paolo Cotogni
Healthcare 2020, 8(2), 102; https://doi.org/10.3390/healthcare8020102 - 17 Apr 2020
Cited by 6 | Viewed by 3916
Abstract
The purpose of this paper is to update the oncologist on the correct approach to the nutritional care of the head and neck cancer patient. Recent scientific contributions on this issue, with a special emphasis on international guidelines and randomised clinical trials (RCTs), [...] Read more.
The purpose of this paper is to update the oncologist on the correct approach to the nutritional care of the head and neck cancer patient. Recent scientific contributions on this issue, with a special emphasis on international guidelines and randomised clinical trials (RCTs), are reviewed. The following points are noteworthy: 1. Despite the advances in early diagnosis and modern treatment of head and neck cancer, this tumour still ranks first regarding frequency and severity of weight loss, both at the clinical presentation and during the therapy. 2. This is due to the combination of poor alimentation because of the tumour mass localization, as well as of the presence of an inflammatory response which furtherly drives catabolism. 3. Several studies have shown a very limited role for a dietary counselling unless it includes oral nutritional supplements which are protein or omega-3 fatty acid enriched. 4. A parental nutritional supplementation could represent an acceptable short-term alternative. 5. Long-term nutritional support relies on the use of percutaneous endoscopic gastrostomy (PEG), whereas the role of a prophylactic or “a la demande” PEG is still unsettled and requires further investigations. In conclusion, the nutritional approach using specific formulas and the appropriate route of administration should be part of the therapeutic armamentarium of the modern oncologist. Full article
(This article belongs to the Special Issue Artificial Nutrition in Cancer Patients)
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