Immunonutrition in Patients with Pancreatic Cancer Undergoing Surgical Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

• Published in: Nutrients Vol. 12; no. 9; p. 2798
• Main Authors: Yang, Fu-An, Chen, Yang-Ching, Tiong, Cheng
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12.09.2020; MDPI
• Subjects: Adult; Bias; Cancer therapies; Clinical trials; Complications; Confidence intervals; Enteral Nutrition - methods; Fatty acids; Female; Humans; Immune system; Immunomodulation; immunonutrition; Infections; Intervention; Length of Stay; Male; Malnutrition; Meta-analysis; Middle Aged; Morbidity; Mortality; Nutrition research; Pancreatectomy; Pancreatic cancer; Pancreatic Neoplasms - physiopathology; Pancreatic Neoplasms - surgery; Patients; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Preoperative Care - methods; Randomized Controlled Trials as Topic; Review; Statistical analysis; Subgroups; Surgery; Systematic review; Treatment Outcome; meta-analysis; pancreatic cancer; immunonutrition; systematic review
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12092798

Immunonutrition is administered to improve the outcome of patients with pancreatic cancer undergoing surgery. However, its effect and mechanism of action remain unclear. Therefore, we conducted this systematic review and meta-analysis to assess its effects on postoperative outcome and the immune system. Randomized controlled trials (RCTs) were identified and data extracted by two reviewers independently from electronic databases from their inception to 31 October 2019. The result was expressed as the risk ratio (RR) for categorical variables and mean difference (MD) for continuous variables with 95% confidence intervals (CIs). Six RCTs published from 1999 and 2016, with a total of 368 patients, were included. The results revealed that immunonutrition significantly decreased the rate of infectious complications (RR = 0.47, 95% CI (0.23, 0.94), = 0.03) and the length of hospital stay (MD = -1.90, 95% CI (-3.78, -0.02), = 0.05) by modulating the immune system, especially in preoperative group in subgroup analysis. We therefore recommend that patients with pancreatic cancer undergoing surgery could take the advantage of immunonutrition, especially in the preoperative period.