Perioperative Nutrition Support for Elective Surgical Cancer Patients: A Narrative Review

Figures & data

Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020. Adapted from Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed). 2021;372:n71.²⁹

Table 1 A List of Examples of Literature That Was Used in the Findings

Author (s)	Publishing Year	Study Design	Objectives	Outcomes/Conclusions
Van Bokhorst-de van der Schueren MA, et al^Citation5	2014	Systematic review	To investigate the construct, criterion, and predictive validity of nutrition screening instruments for the general hospital context.	No screening or assessment tool can accurately screen for nutrition issues or forecast outcomes that are linked to inadequate nutrition.
Cederholm T, et al^Citation9	2019	A consensus report	This initiative is focused on building a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings.	To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present.
Park HM, et al^Citation30	2022	Quasi-experimental	Preoperative nutritional support program (PNSP) among malnourished cancer patients.	Preoperative nutritional support for malnourished pancreatic cancer patients enhances clinical outcomes and nutritional state outcomes.
Haskins IN, et al^Citation19	2017	Comparative study	Association between preoperative hypoalbuminemia and 30-day patient morbidity and mortality in colon cancer patients	Preoperative hypoalbuminemia is associated with an increased risk of early patient morbidity and mortality.
Kwag SJ, et al^Citation16	2014	Cross-sectional	To evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients after surgery for colorectal cancer.	Postoperative complications following colorectal cancer treatment can be predicted by nutritional risk assessment.
Le Roy B, et al^Citation25	2016	Multicentric, randomized, control trial	To evaluate the effect of prehabilitation, compared to conventional care, on the percentage of patients reaching complete oncological treatment.	Perioperative chemotherapy became the gold standard treatment in advanced gastric adenocarcinoma
Kabata P, et al^Citation31	2015	A prospective randomized controlled trial	To assess the need to introduce preoperative nutritional support in patients without malnutrition at qualification for surgery.	Preoperative nutritional support should be introduced for nonmalnourished patients to maintain proper nutritional status as well as to decrease postoperative complications.
Chow R, et al^Citation32	2020	Systematic Review and Meta-analysis	To update the original systematic review and meta-analysis previously published by Chow et al, while also assessing publication quality and the effect of randomized controlled trials (RCTs) on the meta-conclusion over time.	The results support the current European Society of Clinical Nutrition and Metabolism guidelines.
Rajan S, et al^Citation33	2021	A prospective randomized study	To assess the effect of carbohydrate drinks given 2h before surgery on intraoperative blood glucose levels as compared to those who did not receive it.	Compared to patients who received carbohydrate drinks 2 h before surgery, those who did not receive it had significantly higher blood glucose values intraoperatively with a higher incidence and severity of PONV and comparable ICU stay.
Beattie AH, et al^Citation34	2000	A randomized controlled trial	To investigate changes in nutritional status and the influence of oral supplements on nutritional status, morbidity, and quality of life in postoperative surgical patients.	Nutritional status declined for two months after discharge.
Vasiloglou MF, et al^Citation35	2019	A Narrative Review	To explore aspects of effective nutritional counselling, including advances in counselling and areas where nursing input in nutritional counselling might enhance overall nutritional care.	Healthcare professionals require training and education to facilitate a patient centred approach to effective counselling.
Yap A, et al^Citation36	2019	A meta- analysis	To further analyze the effects of propofol (intravenous) and volatile (inhalational gas) anesthesia on cancer recurrence and survival	According to this meta-analysis, patients undergoing cancer surgery may have better recurrence-free survival and overall mortality when they use propofol-total intravenous anesthesia.

Figure 2 Preoperative assessment of cancer patients with malnutrition and optimization.

Figure 3 Components of perioperative prehabilitation of surgical cancer patients.

Figure 4 Preoperative nutrition support recommendations.

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71

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Park HM, Kang YH, Lee DE, Kang MJ, Han -S-S, Park S-J. Effect of preoperative nutritional support in malnourished patients with pancreatobiliary cancer: a quasi-experimental study. BMC Nutr. 2022;8(1):61. doi:10.1186/s40795-022-00555-2

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Haskins IN, Baginsky M, Amdur RL, Agarwal S. Preoperative hypoalbuminemia is associated with worse outcomes in colon cancer patients. Clin Nutr. 2017;36(5):1333–1338. doi:10.1016/j.clnu.2016.08.023

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Kwag SJ, Kim JG, Kang WK, Lee JK, Oh ST. The nutritional risk is a independent factor for postoperative morbidity in surgery for colorectal cancer. Ann Surg Treat Res. 2014;86(4):206–211. doi:10.4174/astr.2014.86.4.206

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Le Roy B, Pereira B, Bouteloup C, et al. Effect of prehabilitation in gastro-oesophageal adenocarcinoma: study protocol of a multicentric, randomised, control trial—the PREHAB study. BMJ open. 2016;6(12):e012876. doi:10.1136/bmjopen-2016-012876

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Kabata P, Jastrzębski T, Kąkol M, et al. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition--prospective randomized controlled trial. Support Care Cancer. 2015;23(2):365–370. doi:10.1007/s00520-014-2363-4

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Chow R, Bruera E, Arends J, et al. Enteral and parenteral nutrition in cancer patients, a comparison of complication rates: an updated systematic review and (cumulative) meta-analysis. Support Care Cancer. 2020;28(3):979–1010. doi:10.1007/s00520-019-05145-w

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Rajan S, Rahman AA, Kumar L. Preoperative oral carbohydrate loading: effects on intraoperative blood glucose levels, post-operative nausea and vomiting, and intensive care unit stay. J Anaesthesiol Clin Pharmacol. 2021;37(4):622–627. doi:10.4103/joacp.JOACP_382_19

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Beattie AH, Prach AT, Baxter JP, Pennington CR. A randomised controlled trial evaluating the use of enteral nutritional supplements postoperatively in malnourished surgical patients. Gut. 2000;46(6):813–818. doi:10.1136/gut.46.6.813

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Vasiloglou MF, Fletcher J, Poulia KA. Challenges and perspectives in nutritional counselling and nursing: a narrative review. J Clin Med. 2019;8(9):1489. doi:10.3390/jcm8091489

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Yap A, Lopez-Olivo MA, Dubowitz J, et al. Anesthetic technique and cancer outcomes: a meta-analysis of total intravenous versus volatile anesthesia. Can J Anesth. 2019;66(5):546–561. doi:10.1007/s12630-019-01330-x

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