Perioperative nutritional assessment and interventions in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC): A systematic review

Gearing, PF; Hawke, JA; Mohan, H; Heriot, AG; Khan, A; Beaumont, A; Laing, E; Waters, PS

Author(s): Gearing, PF; Hawke, JA; Mohan, H; Heriot, AG; Khan, A; Beaumont, A; Laing, E; Waters, PS;
Details: Publication Year 2023-05,Volume 49,Issue #5,Page 902-917
Journal Title: European Journal of Surgical Oncology
Publication Type: Review
Abstract: BACKGROUND: Peritoneal carcinomatosis is a catabolic state and cytoreductive surgery (CRS) is a high morbidity operation. Optimising perioperative nutrition is crucial to improve outcomes. This systematic review sought to examine literature describing clinical outcomes related to preoperative nutrition status and nutrition interventions in patients undergoing CRS with hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: A systematic review was registered with PROSPERO (300326). A search of eight electronic databases was undertaken on 8th May 2022 and reported according to the PRISMA statement. Studies reporting nutrition status through use of screening and assessment tools, nutrition interventions or nutrition-related clinical outcomes for patients undergoing CRS with HIPEC were included. RESULTS: Of 276 screened studies, 25 studies were included for review. Commonly used nutrition assessment tools for CRS-HIPEC patients included Subjective Global Assessment (SGA), sarcopenia assessment with computed tomography, preoperative albumin, and body mass index (BMI). Three retrospective studies compared SGA with postoperative outcomes. Malnourished patients were more likely to have postoperative infectious complications (p = 0.042 SGA-B, p = 0.025 SGA-C). Malnutrition was significantly associated with increased hospital length of stay (LOS) in two studies (p = 0.006, p = 0.02), and with overall survival in another study (p = 0.006). Eight studies analysing preoperative albumin levels reported conflicting associations with postoperative outcomes. BMI in five studies was not associated with morbidity. One study did not support routine nasogastric tube (NGT) feeding. CONCLUSIONS: Preoperative nutritional assessment tools, including SGA and objective sarcopaenia measures, have a role in predicting nutritional status for CRS-HIPEC patients. Optimisation of nutrition is important for preventing complications.
Publisher: Elsevier
Keywords: Humans; Nutrition Assessment; Hyperthermic Intraperitoneal Chemotherapy; Cytoreduction Surgical Procedures/methods; Retrospective Studies; *Hyperthermia, Induced/methods; *Malnutrition/diagnosis/etiology; Combined Modality Therapy; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Survival Rate; Cytoreductive surgery; Hipec; Malnutrition; Nutrition; Surgical oncology
Department(s): Surgical Oncology; Nutrition and Speech Pathology
PubMed ID: 36872111
Publisher's Version: https://doi.org/10.1016/j.ejso.2023.02.015
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-08-15 07:31:25

Last Modified: 2023-08-15 07:32:14