Gastric Cancer (GC), Malnutitrion
Conditions
Keywords
Gastrectomy, Parenteral Nutrition, Oral Nutritional Supplement, Postoperative Recovery, Nutritional Support, Body Weight Loss, Randomized Trial
Brief summary
Patients undergoing gastrectomy for gastric cancer frequently experience insufficient oral intake during the postoperative recovery period because of reduced gastric capacity, early satiety, and gastrointestinal symptoms. Although oral nutritional supplements (ONS) are commonly recommended, adherence is often poor, resulting in a postoperative nutritional gap. This prospective randomized clinical trial was designed to evaluate the impact of combined oral and parenteral nutritional therapy on nutritional status and recovery after gastrectomy for gastric cancer. Patients were randomized to either a combined nutritional therapy group receiving oral nutritional supplementation plus parenteral nutrition or a control group receiving standard postoperative care. The primary endpoint was postoperative body weight change at 4 weeks after surgery. Secondary endpoints included body composition, nutritional intake, inflammatory and immune markers, laboratory parameters, and quality of life outcomes.
Detailed description
Postoperative nutritional deterioration remains a major clinical challenge after gastrectomy for gastric cancer. Reduced gastric capacity and postoperative gastrointestinal symptoms frequently result in inadequate oral intake during the early recovery period. Although oral nutritional supplements are widely recommended, adherence is often poor, potentially leading to insufficient caloric intake and postoperative nutritional deficits. This prospective randomized clinical trial evaluates whether combined oral and parenteral nutritional therapy can improve postoperative nutritional status and recovery compared with standard postoperative care. Patients undergoing curative gastrectomy for gastric cancer are randomized to receive either combined oral nutritional supplementation plus parenteral nutrition or standard postoperative nutritional management. Nutritional outcomes including body weight, body mass index, body composition, inflammatory markers, laboratory nutritional parameters, caloric intake, oral nutritional supplement adherence, and quality of life are assessed during the postoperative recovery period. This study aims to clarify the clinical significance of supplemental parenteral nutrition in bridging the postoperative nutritional gap after gastrectomy.
Interventions
DIETARY_SUPPLEMENTOral Nutritional Supplementation
Patients received oral nutritional supplementation using Encover® three times daily during the postoperative recovery period after gastrectomy for gastric cancer.
OTHERParenteral Nutrition
Supplemental parenteral nutrition was administered during hospitalization and after discharge to support postoperative nutritional requirements.
OTHERStandard Postoperative Nutritional Care
Standard postoperative nutritional management according to institutional clinical pathways, including routine postoperative diet advancement and conventional nutritional support.
Sponsors
Kyo Young Song
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Masking description
Because of the nature of the nutritional intervention, participants and investigators were not blinded to treatment allocation.
Intervention model description
Participants were randomized in a 1:1 ratio to receive either combined oral and parenteral nutritional therapy or standard postoperative nutritional care after gastrectomy for gastric cancer.
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age 20 to 80 years * Histologically confirmed gastric cancer * Scheduled for curative total or subtotal gastrectomy * Ability to tolerate oral intake * Residence within areas covered by home care services * Written informed consent
Exclusion criteria
* Body mass index (BMI) ≥30 kg/m² or \<18.5 kg/m² * Uncontrolled diabetes mellitus * Severe hepatic or renal dysfunction * Active malignancy other than gastric cancer * Previous chemotherapy or radiotherapy * Allergy to oral nutritional supplement products
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Body Weight Change | 4 weeks after surgery | Difference between preoperative body weight and body weight measured at 4 weeks after gastrectomy for gastric cancer. |
Secondary
| Measure | Time frame |
|---|---|
| Body Mass Index Change | 4 weeks after surgery |
Countries
South Korea
Outcome results
None listed