Immunonutrition in major oncologic head and neck surgery: Analysis of complications, plasmatic equilibrium, and costs

• Published in: Head & neck Vol. 45; no. 2; pp. 449 - 463
• Main Authors: Ascoli, Alessandro, Missale, Francesco, Giordano, Giorgio‐Gregory, Vallin, Alberto, Gradaschi, Raffaella, Guiddo, Erica, Schenone, Guido, Sukkar, Samir Giuseppe, Copello, Francesco, Parrinello, Giampiero, Iandelli, Andrea, Peretti, Giorgio, Marchi, Filippo
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2023; Wiley Subscription Services, Inc
• Subjects: albumin; complications; cost analysis; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - complications; Head and Neck Neoplasms - surgery; Humans; immunonutrition; Immunonutrition Diet; Malnutrition; Malnutrition - etiology; Malnutrition - therapy; Nutrition Assessment; Nutritional Status; Patients; Postoperative Complications - prevention & control; Solid tumors; Surgery; Surgical outcomes; complications; head and neck cancer; immunonutrition; cost analysis; albumin; surgery
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.27270

Background Malnutrition, in patients with solid tumors, is associated with a worse clinical outcome and about 40% of patients affected by head and neck cancers (HNC) are malnourished at the time of cancer diagnosis. We investigated the potential benefit of a standardized immunonutritional protocol (INP) to patients with HNC receiving major ablative surgery. Methods An observational study was conducted enrolling 199 patients: 50 treated with the INP and 149 with standard enteral nutrition. Complication rates, need for medications, and costs were considered as outcomes. Results INP played a protective role in development of major surgical complications (OR 0.23, p = 0.023), albumin administration (RR 0.38, p = 0.018), and antibiotic duration (p < 0.001) and is cost‐effective in patients with moderate or severe malnutrition (−6083€ and −11 988€, p < 0.05). Conclusions Our study supports the utility of INP, and accurate nutritional screening can help to identify malnourished patients who would receive the most benefits from this protocol.