Effects of post-discharge oral nutrition supplement on nutritional status and body composition in malnourished patients with gastrointestinal cancer and the clinical implications

Abstract

Abstract Purpose This study aimed to investigate the effects of 3-week post-discharge tumor-specialized ONS (TSONS) on nutritional status, and parameters of anthropometry and body composition in malnourished GIC patients after surgery.Methods A retrospective study was delivered in a real-life clinical setting. GIC adults at risk of malnutrition after surgery from December 2021 to October 2022 were included in this TSONS program. All malnourished GIC patients were recommended to receive hospital-prepared TSONS, containing 18.0% protein, 50.0% fat, and 32.0% carbohydrate per service, to reach 500 kcal per day for up to 3 weeks. Nutritional status was evaluated by Scored Patient-Generated Subjective Global Assessment (PG-SGA). The changes in the clinical outcomes of body composition were compared at 3-week after TSONS from baseline values, stratified by adjuvant chemotherapy status.Results In total, 36 malnourished GIC patients receiving three-week TSONS were included in this analysis. Three-week TSONS improved nutritional status (P < 0.001). However, TSONS did not significantly impact body composition. When stratified by chemotherapy status, although the difference did not reach a significant level, more weight gain and improved body composition were observed in the patients not receiving adjuvant chemotherapy, and of these in patients with normal muscle mass in particular. Meanwhile, a slight rise in fat mass along with visceral fat was promoted by adjuvant chemotherapy, especially for sarcopenic patients.Conclusion Three-week post-discharge TSONS could benefit nutritional status in malnourished GIC patients after surgery. However, it did not have a significant impact on the increase in body weight and improvement of body composition through one-chemotherapy cycle of TSONS.