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The effect of perioperative immunonutritional support on nutritional and inflammatory status in patients undergoing lung cancer surgery: a prospective, randomized controlled study

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Abstract

Purpose

Nutritional status is affected in patients who undergo lung cancer surgery (LCS). This study is aimed at investigating the effects of the use of immunonutritional support in the perioperative period on nutritional and inflammatory status in patients undergoing LCS.

Methods

A single-center, prospective, randomized controlled clinical trial was conducted with seventy patients planning to have LCS and randomized into treatment (TG) and control groups (CG). Immunonutritional support was given orally twice a day for ten days before the operation and five days after the operation in the treatment group. The nutritional status of the patients was screened with the Patient-Generated Subjective Global Assessment (PG-SGA); the Prognostic Nutrition Index (PNI) and the Systemic Inflammation Index (SII) were calculated. The physical activity status was assessed with the Eastern Cooperative Oncology Group Performance Status (ECOG-PS).

Results

Post-op nutritional status of the TG patients was better than the CG group (p = 0.009). Post-operative PG-SGA score was higher than preoperative PG-SGA score in both groups (p < 0.001). In the post-operative period, nutritional status (in terms of PG-SGA score category) in the patients in the TG was better than the CG (p = 0.046). In both groups, post-op ECOG score was higher than the pre-op ECOG score (p < 0.001). Post-op physical performance status was found to be better in the TG compared to the CG (p = 0.001). PNI level decreased statistically and significantly in the post-op period compared to the pre-op period, SII levels increased.

Conclusion

Patients who will undergo LCS should be supported in terms of immunonutrition starting from the preoperative period.

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Data Availability

The datasets of the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank all patients and their families who participated in the study. In addition, we would like to thank all the healthcare professionals who assisted in the study at the Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, where the study was conducted.

Funding

This research was supported financially as part of 1002 Project support by the TÜBİTAK (The Scientific and Technological Research Council of Turkey) (Project no: 120S720).

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Authors and Affiliations

  1. Nutrition and Diet Department, Republic of Turkey Ministry of Health İzmir Provincial Health Directorate Health Sciences University Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, İzmir, Turkey

    Gokce Gunsel-Yildirim

  2. Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Ankara, Turkey

    Gokce Gunsel-Yildirim & Derya Dikmen

  3. Thoracic Surgery Department, Republic of Turkey Ministry of Health İzmir Provincial Health Directorate Health Sciences University Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, İzmir, Turkey

    Kenan Can Ceylan

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  1. Gokce Gunsel-Yildirim
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Contributions

Study design: DD and GGY; data collection: GGY and KCC; data analysis and wrote the main manuscript: GGY and DD; all authors reviewed the manuscript.

Corresponding author

Correspondence to Derya Dikmen.

Ethics declarations

Ethics approval

The study was conducted in accordance with the principles of good clinical practice in the Declaration of Helsinki. The ethics committee approval was obtained from the Health Sciences University Izmir Bozyaka Training and Research Hospital Clinical Research Ethics Committee (11.09.2019 and decision no:08) and the Republic of Turkey Ministry of Health Turkish Medicines and Medical Devices Agency Clinical Researches Committee (03.10.2019 and document no: E.154168). Written informed consent was obtained from all patients before inclusion in the study.

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The authors declare no competing interests.

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Gunsel-Yildirim, G., Ceylan, K.C. & Dikmen, D. The effect of perioperative immunonutritional support on nutritional and inflammatory status in patients undergoing lung cancer surgery: a prospective, randomized controlled study. Support Care Cancer 31, 365 (2023). https://doi.org/10.1007/s00520-023-07838-9

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