Clinical Nutrition Open Science (Feb 2022)

Effects of artificial nutrition and hydration on survival in patients with head and neck cancer and esophageal cancer admitted to palliative care units

  • Sayuri Yokota,
  • Koji Amano,
  • Shunsuke Oyamada,
  • Hiroto Ishiki,
  • Isseki Maeda,
  • Tomofumi Miura,
  • Yutaka Hatano,
  • Yu Uneno,
  • Tetsuo Hori,
  • Yosuke Matsuda,
  • Hiroyuki Kohara,
  • Kozue Suzuki,
  • Tatsuya Morita,
  • Masanori Mori,
  • Satoshi Inoue,
  • Naosuke Yokomichi,
  • Kengo Imai,
  • Hiroaki Tsukuura,
  • Toshihiro Yamauchi,
  • Akemi Shirado Naito,
  • Akira Yoshioka,
  • Shuji Hiramoto,
  • Ayako Kikuchi,
  • Keiko Tanaka,
  • Tina Kamei,
  • Yukari Azuma,
  • Teruaki Uno,
  • Jiro Miyamoto,
  • Hirofumi Katayama,
  • Hideyuki Kashiwagi,
  • Eri Matsumoto,
  • Kiyofumi Oya,
  • Takeya Yamaguchi,
  • Tomonao Okamura,
  • Hoshu Hashimoto,
  • Shunsuke Kosugi,
  • Nao Ikuta,
  • Yaichiro Matsumoto,
  • Takashi Ohmori,
  • Takehiro Nakai,
  • Takashi Ikee,
  • Yuto Unoki,
  • Kazuki Kitade,
  • Shu Koito,
  • Nanao Ishibashi,
  • Masaya Ehara,
  • Kosuke Kuwahara,
  • Shohei Ueno,
  • Shunsuke Nakashima,
  • Yuta Ishiyama,
  • Akihiro Sakashita,
  • Ryo Matsunuma,
  • Hana Takatsu,
  • Takashi Yamaguchi,
  • Satoko Ito,
  • Toru Terabayashi,
  • Jun Nakagawa,
  • Tetsuya Yamagiwa,
  • Akira Inoue,
  • Takuhiro Yamaguchi,
  • Mitsunori Miyashita,
  • Saran Yoshida,
  • Yusuke Hiratsuka,
  • Keita Tagami,
  • Hiroaki Watanabe,
  • Takuya Odagiri,
  • Tetsuya Ito,
  • Masayuki Ikenaga,
  • Keiji Shimizu,
  • Akira Hayakawa,
  • Rena Kamura,
  • Takeru Okoshi,
  • Tomohiro Nishi,
  • Kazuhiro Kosugi,
  • Yasuhiro Shibata,
  • Takayuki Hisanaga,
  • Takahiro Higashibata,
  • Ritsuko Yabuki,
  • Shingo Hagiwara,
  • Miho Shimokawa,
  • Satoshi Miyake,
  • Junko Nozato,
  • Specially Appointed,
  • Tetsuji Iriyama,
  • Keisuke Kaneishi,
  • Mika Baba,
  • Yoshihisa Matsumoto,
  • Ayumi Okizaki,
  • Yuki Sumazaki Watanabe,
  • Yuko Uehara,
  • Eriko Satomi,
  • Kaoru Nishijima,
  • Junichi Shimoinaba,
  • Ryoichi Nakahori,
  • Takeshi Hirohashi,
  • Jun Hamano,
  • Natsuki Kawashima,
  • Takashi Kawaguchi,
  • Megumi Uchida,
  • Ko Sato,
  • Yoichi Matsuda,
  • Satoru Tsuneto,
  • Sayaka Maeda,
  • Yoshiyuki Kizawa,
  • Hiroyuki Otani

Journal volume & issue
Vol. 41
pp. 33 – 43

Abstract

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Summary: Background: The benefits of artificial nutrition and hydration in patients with head and neck cancer and esophageal cancer in the late stage remain unknown. We performed a secondary analysis of a cohort study to investigate the effects of enteral tube feeding (ETF) and parenteral nutrition and hydration (PNH) on survival in this population. Methods: Patients with head and neck cancer and esophageal cancer admitted to palliative care units were included. Information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate/total calorie intake, e.g., 75%≤/750 kcal/day≤ and <25%/<250 kcal/day, were obtained. Patients were divided into oral intake-, ETF-, and PNH-groups. We performed time-to-event analyses using the Kaplan-Meier method, Log-rank test, and univariate and multivariate Cox regression analyses. Results: There were 33 patients in the oral intake-group, 25 in the ETF-group, and 44 in the PNH-group. A significant difference was observed in survival rates between these groups (Log-rank P = 0.002), and median survival times were 54.0 (95% CI 33–75), 26.0 (95% CI 13–39), and 18.0 (95% CI 14–22) days, respectively. In the multivariate-adjusted model, the oral intake-group had a significantly lower risk of mortality than the PNH-group [HR 0.46 (95% CI 0.28–0.76), P = 0.002], while the ETF-group had a markedly lower risk of mortality than the PNH-group [HR 0.60 (95% CI 0.34–1.06), P = 0.077]. Conclusions: These results indicate the potentially beneficial effects of ETF for patients with head and neck cancer and esophageal cancer in palliative care.

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