Intake and Nutritional Adequacy in Patients With Cancer Diagnosed With Malignant Bowel Obstruction: A Secondary Analysis of a Randomized Trial - 18/04/25
, Kathryn B. Arnold, MS 2, Garnet Anderson, PhD 3, Virginia Sun, PhD 4, Angeles Alvarez Secord, MD, MHSc 5, 6, Angela Yung, MBA, RD 7, Mazin Al-Kasspooles, MD 8, Valentine N. Nfonsam, MD, MS, FACS, FASCRS 9, Marcia Grant, PhD, RN 10, Gary B. Deutsch, MD, MPH, FACS, FSSO 11, 12, Jeremiah L. Deneve, DO, FACS 13, Robert S. Krouse, MD 14, 15, 16Abstract |
Background |
Malignant bowel obstruction (MBO) is experienced by many with advanced cancer. Patients with MBO cannot eat and may have reduced ability to eat once the acute process has resolved. Sparse data exist to describe oral intake capacity and adequacy of nutrition in patients with MBO. These data are critical to developing effective supportive care nutrition therapy for patients with MBO.
Objective |
The aim of this study was to describe the ability to consume food and liquids orally, estimating nutritional adequacy of diet in a sample of patients who received surgical or nonsurgical treatment for MBO.
Design |
A descriptive secondary data analysis of repeated dietary intake measures from S1316, a pragmatic comparative effectiveness trial of surgical and nonsurgical treatment for MBO. Participant enrollment occurred between 2015 and 2020. Ability to eat was assessed through self-reported telephone survey and intake was estimated using telephone-based 24-hour recalls, applying US Department of Agriculture multipass methodology.
Participants/setting |
The primary trial was conducted within the SWOG Cancer Research Network and included recruitment sites across the United States and Latin America. Eligible participants were diagnosed with, and hospitalized for, MBO.
Main outcome measures |
The main outcomes measures were self- or caregiver-reported ability to eat, as well as overall nutrient intake.
Statistical analysis |
Descriptive statistics were used to report patient characteristics, intake, and nutrient adequacy. Nutrient intake was presented by tertiles of gastrointestinal symptom severity and assessed.
Results |
Two hundred twenty-one participants were registered; 199 were eligible and included. At week 1, 51% of patients with MBO reported consuming some solid food orally; 34% reported no oral intake; and 13% were on enteral feeding only. For patients alive and responsive to recalls at 13 weeks (n = 57), 82% (n = 47) reported consuming solid food. Compared with recommendations, mean reported intake was inadequate for most nutrients.
Conclusions |
Oral intake is reported in more than one-half of patients diagnosed with MBO. Medical nutrition therapy should be tailored to patient’s tolerance for eating and with consideration or patient’s desire to address nutritional inadequacies.
Le texte complet de cet article est disponible en PDF.Keywords : Malignant bowel obstruction, Cancer, Dietary intake, Nutrient adequacy, Supportive care
Plan
| Supplementary materials:Figure 1 and Table 5, Table 8 are available at www.jandonline.org/ |
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| STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. |
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| FUNDING/SUPPORT Supported by P30 CA023074/CA/NCI NIH HHS/United States, R01 HS021491/HS/AHRQ HHS/United States, and UG1 CA189974/CA/NCI NIH HHS/United States. |
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| AUTHOR CONTRIBUTIONS R. S. Krouse lead the research project and generated the research idea with V. Sun. C. A. Thomson identified the research question of diet-related data collection, analysis and interpretation and led manuscript writing. V. Sun, A. Alvarez Secord, A. Yung, M. Al-Kasspooles, V. N. Nfonsam, M. Grant, G. B. Deutsch, J. L. Deneve, and R. S. Krouse supported data collection. K. B. Arnold supported data management, authored the statistical methods, and provided data analysis. G. Anderson provided guidance on study design and statistical analysis. All authors reviewed and commented on subsequent manuscript drafts. |
Vol 125 - N° 5
P. 654 - mai 2025 Retour au numéro
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