Nutritional support in patients with oesophageal cancer



Obesity and overweight are risk factors for developing an oesophageal cancer, especially the adenocarcinoma in the distal oesophagus or at the gastroesophageal junction, and many patients still are overweight at the clinical presentation even if they are losing weight. Main mechanisms involved in weight loss are a decreased nutrients’ intake and an alteration in metabolism due to a cytokine-driven inflammatory status. Malnutrition is a risk factor for a poor compliance to chemotherapy and radiation therapy and finally for the oncologic outcome. There is scientific evidence that frequently both conditions exist but in the advanced stages of disease metabolic alterations play a major role and are responsible for the poor response to nutritional support.


The literature about the nutritional support in patients with cancer of the oesophagus has been reviewed with special emphasis on randomised clinical trials whenever available. In surgical patients, both overweight and weight loss increase the risk of postoperative complications.


In non-dysphagic patients receiving a neo-adjuvant oncologic treatment, the simple use of oral nutritional supplements is little effective in ameliorating the nutritional status, in contrast, an intensive dietetic surveillance associated with oral supplements can lead to better nutritional status, improved quality of life and better compliance with therapy. In dysphagic patients, many comparative non-randomised clinical studies have shown clinical benefits from tube feeding on the nutritional status and compliance with therapy. There is no apparent difference on the metabolic efficacy of the enteral versus parenteral nutrition. Studies on peri-operative nutrition in oesophagectomy patients were often underpowered and, hence, inconclusive, but the large experience on the nutritional support in patients with gastrointestinal cancer undergoing major abdominal surgery has clearly shown the benefits of the enteral nutrition. Both the American and the European Society for Parenteral and Enteral Nutrition have recognised a grade A recommendation for the nutritional support of malnourished gastrointestinal cancer patients undergoing major surgery.


In patients with oesophageal cancer on chemotherapy and/or radiation therapy, enteral nutrition (oral supplements ± intensive counselling or tube feeding) is nutritionally and clinically beneficial. In surgical patients, a broad experience in major abdominal surgery supports the peri-operative use of enteral nutrition and especially of immune-enteral nutrition.

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  1. 1.

    Aiko S, Yoshimi Y, Ishizuka T, Horio T et al (2008) Enteral immuno-enhanced diets with arginine are safe and beneficial for patients early after esophageal cancer surgery. Dis Esophagus 21:619–627. doi:10.1111/j.1442-2050.2008.00827.x

    Article  PubMed  Google Scholar 

  2. 2.

    Altman DG, Bland JM (1995) Absence of evidence is not evidence of absence. BMJ 311:485

    CAS  PubMed  Google Scholar 

  3. 3.

    Arnold C, Richter MP (1989) The effect of oral nutritional supplements on head and neck cancer. Int J Radiat Oncol Biol Phys 16(6):1595–1599

    CAS  PubMed  Google Scholar 

  4. 4.

    Baigrie RJ, Devitt PG, Watkin DS (1996) Enteral versus parenteral nutrition after oesophagogastric surgery: a prospective randomized comparison. Aust N Z J Surg 66:668–670. doi:10.1111/j.1445-2197.1996.tb00714.x

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Bailey SH, Bull DA, Harpole DH et al (2003) Outcomes after esophagectomy: a ten-year prospective cohort. Ann Thorac Surg 75:217–222. doi:10.1016/S0003-4975(02)04368-0

    Article  PubMed  Google Scholar 

  6. 6.

    Barber MD, Fearon KC, McMillan DC et al (2000) Liver export protein synthetic rate are increased by oral mel feeding in weight-losing cancer patients. Am J Physiol Endocrinol Metab 279:E707–E714

    CAS  PubMed  Google Scholar 

  7. 7.

    Belghiti J, Langonnet E, Bourstiyn E, Feketè F (1983) Surgical implications of malnutrition and immunodeficiency in patients with carcinoma of the esophagus. Br J Surg 70:339–341. doi:10.1002/bjs.1800700610

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Blee TH, Belzer GE, Lambert PJ (2002) Obesity: is there an increase in perioperative complications in those undergoing elective colon and rectal resection for carcinoma? Am Surg 68:163–166

    PubMed  Google Scholar 

  9. 9.

    Bozzetti F, Cozzaglio L, Gavazzi C et al (1998) Nutritional support in patients with cancer of the esophagus: impact on nutritional status, patient compliance to therapy, and survival. Tumori 84(6):681–686

    CAS  PubMed  Google Scholar 

  10. 10.

    Bozzetti F, Gianotti L, Braga M, Di Carlo V, Mariani L (2007) Postoperative complications in gastrointestinal cancer patients: the joint role of the nutritional status and the nutritional support. Clin Nutr 26:698–709. doi:10.1016/j.clnu.2007.06.009

    Article  PubMed  Google Scholar 

  11. 11.

    Bozzetti F, Migliavacca S, Scotti A, Bonalumi MG et al (1982) Impact of cancer type, site, stage and treatment on the nutritional status of patients. Ann Surg 196:170–179

    Article  Google Scholar 

  12. 12.

    Bozzetti F, SCRINIO Working Group (2009) Screening the nutritional status in oncology: a preliminary report on 1000 outpatients. Supp Care Cancer 17:279–284

    Article  Google Scholar 

  13. 13.

    Braga A, Ljungqvist O, Soeters PB, Fearon K, et al (2009) ESPEN Guidelines on Parenteral Nutrition: Surgery. Clin Nutr (in press).

  14. 14.

    Brown LM, Swanson CA, Gridley G et al (1995) Adenocarcinoma of the esophagus: role of obesity and diet. J Natl Cancer Inst 87:104–109. doi:10.1093/jnci/87.2.104

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Burt ME, Gorschboth CM, Brennan MF (1982) A controlled, prospective, randomized trial evaluating the metabolic effects of enteral and parenteral nutrition in the cancer patient. Cancer 49:1092–1105. doi:10.1002/1097-0142(19820315) 49:6<1092::AID-CNCR2820490606>3.0.CO;2-9

    Article  CAS  PubMed  Google Scholar 

  16. 16.

    Burt ME, Stein TP, Brennan MF (1983) A controlled, randomized trial evaluating the effects of enteral and parenteral nutrition on protein metabolism in cancer-bearing man. J Surg Res 34:303–314. doi:10.1016/0022-4804(83)90076-8

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Buzby GP, Mullen JL, Mattews DC et al (1980) Prognostic nutritional index in gastrointestinal surgery. Am J Surg 139:160–167. doi:10.1016/0002-9610(80)90246-9

    Article  CAS  PubMed  Google Scholar 

  18. 18.

    Campos AC, Butters M, Meguid MM (1990) Home enteral nutrition via gastrostomy in advanced head and neck cancer patients. Head Neck 12(2):137–142. doi:10.1002/hed.2880120208

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Chow WH, Blot WJ, Vaughan TL et al (1998) Body mass index and risk of the esophagus and gastric cardia. J Natl Cancer Inst 90:150–155. doi:10.1093/jnci/90.2.150

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Conti S, West J, Fitzpatrick HF (1997) Mortality and morbidity after esophagogastrectomy for cancer of the esophagus and cardia. Am Surg 43:92–96

    Google Scholar 

  21. 21.

    Crumley ABC, McMillan M, McKennan M et al (2006) Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer. Br J Cancer 94:437–441

    Google Scholar 

  22. 22.

    Daly JM, Fry WA, Little AG, Winchester DP et al (2000) Esophageal cancer: results of an American College of Surgeons’ Patient Care Evaluation Study. J Am Coll Surg 190:562–573. doi:10.1016/S1072-7515(00)00238-6

    Article  CAS  PubMed  Google Scholar 

  23. 23.

    Daly JM, Weintraub FN, Shou J, Rosato EF, Lucia M (1995) Enteral nutrition during multimodality therapy in upper gastrointestinal cancer patients. Ann Surg 221(4):327–338. doi:10.1097/00000658-199504000-00002

    Article  CAS  PubMed  Google Scholar 

  24. 24.

    Deans DA, Tan BH, Ross JA, Rose-Zerilli M, Wigmore SJ, Howell WM, Grimble RF, Fearon KC (2009) Cancer cachexia is associated with the IL10-1082 gene promoter polymorphism in patients with gastroesophageal malignancy. Am J Clin Nutr 89:1164–1172.

    Article  CAS  PubMed  Google Scholar 

  25. 25.

    Deans DC, Tan BH, Wigmore SJ et al (2009) The influence of systemic inflammation, dietary intake and stage of disease on rate of weight loss in patients with gastro-esophageal cancer. Br J Cancer 100:63–69. doi:10.1038/sj.bjc.6604828

    Article  CAS  PubMed  Google Scholar 

  26. 26.

    Dempsey DT, Feurer ID, Knox LS, Crosby LO et al (1984) Energy expenditure in malnourished gastrointestinal cancer patients. Cancer 53:1265–1273. doi:10.1002/1097-0142(19840315) 53:6<1265::AID-CNCR2820530609>3.0.CO;2-2

    Article  CAS  PubMed  Google Scholar 

  27. 27.

    Dickerson RN, Boschert KJ, Kudsk SA et al (2002) Hypocaloric enteral tube feeding in critically ill obese patients. Nutrition 18:241–246. doi:10.1016/S0899-9007(01)00793-6

    Article  PubMed  Google Scholar 

  28. 28.

    Dietitians Association of Australia Evidence Based Practice Guidelines for the Nutritional Management of Patients Receiving Radiation therapy (2008). Nutr&Diet 65 (Suppl 1) S1-S2

  29. 29.

    DiFiore F, Lecleire S, Pop D, Rigal O et al (2007) Baseline nutritional status is predictive of response to treatment and survival in patients treated by definitive chemoradiotherapy for a locally advanced esophageal cancer. Am J Gastroenterol 102:2557–2563. doi:10.1111/j.1572-0241.2007.01437.x

    Article  CAS  Google Scholar 

  30. 30.

    Dresler CM, Jeevanandam M, Brennan MF (1987) Metabolic efficacy of enteral feeding in malnourished cancer and noncancer patients. Metabolism 36:82–88. doi:10.1016/0026-0495(87)90068-0

    Article  CAS  PubMed  Google Scholar 

  31. 31.

    Fettes SB, Davidson HJ, Richardson RA et al (2002) Nutritional status of elective gastrointestinal surgery patients pre-and post-operatively. Clin Nutr 21:249–254. doi:10.1054/clnu.2002.0540

    Article  PubMed  Google Scholar 

  32. 32.

    Fietkau R, Iro H, Sailer D, Sauer R (1991) Percutaneous endoscopically guided gastrostomy in patients with head and neck cancer. Rec Res Cancer Res 121:269–282

    CAS  Google Scholar 

  33. 33.

    Gabor S, Renner H, Matzi V, Ratzenhofer B et al (2005) Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction. Br J Nutr 93:509–513. doi:10.1079/BJN20041383

    Article  CAS  PubMed  Google Scholar 

  34. 34.

    Garcia_Peris P, Lozano MA, Velasco C et al (2005) Prospective study on restino energy expenditure in head and neck cancer patients treated with chemoradiation measured by in direct calorimetry. Nutrition 21:1107–1112

    Article  PubMed  Google Scholar 

  35. 35.

    Gibbs-Ward A, Keller HH (2005) Mealtimes as active processes in long-term care facilities. Can J Diet Pract Res 66:5–11. doi:10.3148/66.1.2005.5

    Article  PubMed  Google Scholar 

  36. 36.

    Haffejee AA, Angorn IB, Brain PP, Duursma J et al (1978) Diminished cellular immunity due to impaired nutrition in oesophageal carcinoma. Br J Surg 65:480–482. doi:10.1002/bjs.1800650710

    Article  CAS  PubMed  Google Scholar 

  37. 37.

    Haffejee AA, Angorn IB (1979) Nutritional status and non-specific cellular and humoral immune response in esophageal carcinoma. Ann Surg 189:475–479. doi:10.1097/00000658-197904000-00015

    Article  CAS  PubMed  Google Scholar 

  38. 38.

    Healy LA, Ryan AM, Gopinath B et al (2007) Impact of obesity in the management of localized adenocarcinoma of the esophagus and esophagogastric junction. J Thorac Cardiovasc Surg 134:1284–1291. doi:10.1016/j.jtcvs.2007.06.037

    Article  PubMed  Google Scholar 

  39. 39.

    Heatley RV, Williams RHP, Lewis MH (1979) Preoperative intravenous feeding. A controlled trial. Postgrad Med J 55:541–545. doi:10.1136/pgmj.55.646.541

    Article  CAS  PubMed  Google Scholar 

  40. 40.

    Jl H, Baracos VE, Wismer WV (2007) Chemosensory dysfunction is a primary factor in the evolution of d15eclining nutritional status and quality of life in patients with advanced cancer. J Pain Symptom Manage 33:6–165. doi:10.1016/j.jpainsymman.2006.08.004

    Article  Google Scholar 

  41. 41.

    Isenring EA, Capra S, Bauer JD (2004) Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer 91(3):447–452. doi:10.1038/sj.bjc.6601962

    Article  CAS  PubMed  Google Scholar 

  42. 42.

    Iwasa M (1983) Nutritional assessment of patients with esophageal cancer. “Nutritional Assessment Index (NAI)” to estimate nutritional conditions in pre-and postoperative period. Nippon Geka Gakkai Zasshi 84:1031–1041

    CAS  PubMed  Google Scholar 

  43. 43.

    Jeevanadam M, Young DH et al (1991) Obesity and the metabolic response to severe multiple trauma in man. J Clin Invest 87:262–269. doi:10.1172/JCI114980

    Article  Google Scholar 

  44. 44.

    Jeevanandam M, Horowitz GD, Lowry SF et al (1985) Cancer cachexia: effect of total parenteral nutrition on whole body protein kinetics in man. JPEN J Parenter Enteral Nutr 9:10

    Google Scholar 

  45. 45.

    Jenkinson AD, Lim J, Agrawal N, Menzies D (2007) Laparorscopic feeding jejunostomy in esophagogastric cancer. Surg Endosc 21:299–302. doi:10.1007/s00464-005-0727-z

    Article  CAS  PubMed  Google Scholar 

  46. 46.

    Jordan S, Philpin S, Warring J et al (2006) Percutaneous endoscopic gastrostomies: the burden of treatment from a patient perspective. J Adv Nurs 56:270–281. doi:10.1111/j.1365-2648.2006.04006.x

    Article  PubMed  Google Scholar 

  47. 47.

    Lagergen J, Bergstrom R, Nyren O (1999) Association between body mass index and adenocarcinoma of the esophagus and gastric cardia. Ann Intern Med 130:883–890

    Google Scholar 

  48. 48.

    Lee JH, Machtay M, Unger LD et al (1998) Prophylactic gastrostomy tubes in patients undergoing intensive irradiation for cancer of the head and neck. Arch Otolaryngol Head Neck Surg 124:871–875

    CAS  PubMed  Google Scholar 

  49. 49.

    Lim STK, Choa RG, Lan KH, Ong GB (1981) Total parenteral nutrition versus gastrostomy in the preoperative preparation of patients with carcinoma of the oesophagus. Br J Surg 68:69–72. doi:10.1002/bjs.1800680202

    Article  CAS  PubMed  Google Scholar 

  50. 50.

    Marcy PY, Magne N, Bensadoun RJ et al (2000) Systematic percutaneous fluoroscopic gastrostomy for concomitant radiochemotherapy of advanced head and neck cancer: optimization of therapy. Support Care Cancer 8:410–413. doi:10.1007/s005200050010

    Article  CAS  PubMed  Google Scholar 

  51. 51.

    Margolis M, Alexander P, Trachiotis GD et al (2001) Percutaneous endoscopic gastrostomy before multimodal therapy in patients with esophageal cancer. Ann Thorac Surg 76:1694–1697. doi:10.1016/S0003-4975(02)04890-7

    Article  Google Scholar 

  52. 52.

    Martin CA, Walsh GL, Moreland K (1999) Relationship of weight loss and postoperative nutritional complications in esophagogastrectomy surgery. JPEN J Parenter Enteral Nutr 23:S20

    Article  Google Scholar 

  53. 53.

    McWhirther JP, Pennington CR (1994) Incidence and ecognition of malnutrition in hospital. BMJ 308:945–948

    Google Scholar 

  54. 54.

    Mekhail TM, Adelstein D, Rybicki LA et al (2001) Enteral nutrition during the treatment of head and neck carcinoma:is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer 91:1785–1790. doi:10.1002/1097-0142(20010501) 91:9<1785::AID-CNCR1197>3.0.CO;2-1

    Article  CAS  PubMed  Google Scholar 

  55. 55.

    Moghissi K, Hornshaw TPR, Dawes EA (1977) Parenteral nutrition in carcinoma of the oesophagus treated by surgery: nitrogen balance and clinical studies. Br J Surg 64:125–128. doi:10.1002/bjs.1800640211

    Article  CAS  PubMed  Google Scholar 

  56. 56.

    Moloney M, Mortarty M, Daly L (1983) Controlled studies of nutritional intake in patients with malignant disease undergoing treatment. Hum Nutr Appl Nutr 37A:30–35

    Google Scholar 

  57. 57.

    Nayel H, el-Ghoneimy E, el-Saddah S (1992) Impact of the nutritional supplementation on treatment delay and morbidity in patients with head and neck tumour treated with irradiation. Nutrition 18:13–18

    Google Scholar 

  58. 58.

    Nozoe T, Kimura Y, Ishida M, Saeki H et al (2002) Correlation of preoperative nutritional condition with postoperative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol 28:396–400. doi:10.1053/ejso.2002.1257

    Article  CAS  PubMed  Google Scholar 

  59. 59.

    Oates JE, Clark JR, Read J et al (2007) Prospective evaluation of quality of life and nutrition before and after treatment for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 10(33):533–554. doi:10.1001/archotol.133.6.533

    Article  Google Scholar 

  60. 60.

    Odelli C, Burgess D, Bateman L et al (2005) Nutrition support improves outcomes, treatment tolerance and admission characteristics in oesophageal cancer. Clin Oncol (R Coll Radiol) 17:639–645. doi:10.1016/j.clon.2005.03.015

    CAS  Google Scholar 

  61. 61.

    Paccagnella A, Mauri A, Berto R et al (2007) Biopsychosocial approach to home enteral nutrition: measure of subjective satisfaction and quality of life. Minerva Med 38:5–17

    Google Scholar 

  62. 62.

    Padilla GV, Grant MM (1985) Psychosocial aspects of artificial feeding. Cancer 55:301–304. doi:10.1002/1097-0142(19850101) 55:1+<301::AID-CNCR2820551316>3.0.CO;2-B

    Article  CAS  PubMed  Google Scholar 

  63. 63.

    Page RD, Oo AY, Russell GN, Pannefather SH (2002) Intravenous hydration versus nasojeunal enteral feeding after esophagectomy: a randomised study. Eur J Cardiothorac Surg 22:666–672. doi:10.1016/S1010-7940(02)00489-X

    Article  PubMed  Google Scholar 

  64. 64.

    Pearlstone DB, Lee J, Alexander RH et al (1995) Effect of enteral and parenteral nutrition on amino acid levels in cancer patients. JPEN J Parenter Enteral Nutr 19:204–208. doi:10.1177/0148607195019003204

    Article  CAS  PubMed  Google Scholar 

  65. 65.

    Pedersen H, Hansen HS, Cederqvist C, Leber J (1982) The prognostic significance of weight loss and its integration in stage-grouping of oesophageal cancer. Acta Chir Scand 148:363–366

    CAS  PubMed  Google Scholar 

  66. 66.

    Preston T, Slater C, McMillan DC et al (1998) Fibrinogen synthesis is elevated in fasting cancer patients with acute phase response. J Nutr 128:1355–1360

    CAS  PubMed  Google Scholar 

  67. 67.

    Ravasco P, Monteiro-Grillo I, Vidal PM et al (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27:669–668. doi:10.1002/hed.20221

    Article  Google Scholar 

  68. 68.

    Reynolds JV, Kanwar S, Welsch FKS et al (1997) Does the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery? JPEN J Parenter Enteral Nutr 21:196–201. doi:10.1177/0148607197021004196

    Article  CAS  PubMed  Google Scholar 

  69. 69.

    Roberge C, Tran M, Massoud C et al (2000) Quality of life and home enteral feeding: a French Study in patients with head and neck or oesophageal cancer. Br J Cancer 82:263–269. doi:10.1054/bjoc.1999.0913

    Article  CAS  PubMed  Google Scholar 

  70. 70.

    Rogers SN, Thomson R, O’toole P, Lowe D (2007) Patients experience with long-term percutaneous endoscopic gastrostomy feeding following primary surgery for oral and oropharyngeal cancer. Oral Oncol 43:499–507. doi:10.1016/j.oraloncology.2006.05.002

    Article  PubMed  Google Scholar 

  71. 71.

    Ryan AM, Healy LA, Power DG et al (2008) Barrett esophagus: prevalence of central adiposity, metabolic syndrome, and a proinflammatory state. Ann Surg 247:909–915. doi:10.1097/SLA.0b013e3181612cac

    Article  PubMed  Google Scholar 

  72. 72.

    Ryan AM, Rowley SP, Healy LA, Flood PM, Ravi N, Reynolds JV (2006) Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit. Clin Nutr 25:386–393. doi:10.1016/j.clnu.2005.12.003

    Article  PubMed  Google Scholar 

  73. 73.

    Ryan AM, Reynolds JV, Healy L, Byrne M, Moore J, Brannelly N, McHugh A, McCormack D, Flood P (2009) Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following oesophageal cancer surgery: results of a double-blinded randomized controlled trial. Ann Surg 249:355–363. doi:10.1097/SLA.0b013e3181983231

    Article  PubMed  Google Scholar 

  74. 74.

    Sakurai Y, Masui T, Yoshida I, Tonomura S et al (2007) Randomised clinical trial on the effects of perioperative use of immune-enhancing enteral formula on the metabolic and immunologic status of patients undergoing esophagectomy. World J Surg 31:2150–2157. doi:10.1007/s00268-007-9170-8

    Article  PubMed  Google Scholar 

  75. 75.

    Schattner M, Willis H, Raykher A et al (2005) Long term enteral nutrition facilitates optimization of body weight. JPEN J Parenter Enteral Nutr 29:198–203. doi:10.1177/0148607105029003198

    Article  PubMed  Google Scholar 

  76. 76.

    Scottish Intercollegiate Guidelines Network SIGN guidelines- an introduction to SIGN methodology for the development of evidence-based clinical guidelines. Edinburgh, SIGN Publication No.39, SIGN Secretariat, Royal College of Physicians of Edinburgh, 1999

  77. 77.

    Senft M, Fietkau R, Iro H et al (1993) The influence of supportive nutritional therapy via percutaneous endoscopically guided gastrostomy on the quality of life of cancer patients. Support Care Cancer 1:272–275

    Article  CAS  PubMed  Google Scholar 

  78. 78.

    Shaw JH, Wolfe RR (1988) Whole-body protein kinetics in patients with early and advanced gastrointestinal cancer: the response to glucose infusion and total parenteral nutrition. Surgery 103:148–155

    CAS  PubMed  Google Scholar 

  79. 79.

    Shims EJ, Mehnert A, Koyama A et al (2006) Health-related quality of life in breast cancer: a cross cultural survey of German, Japanese, and South Korean patients. Breast Cancer Res Treat 99:341–350. doi:10.1007/s10549-006-9216-x

    Article  Google Scholar 

  80. 80.

    Simms JM, Olliver E, Smith JAR (1980) A study of total parenteral nutrition (TPN) in major gastric and esophageal resection for neoplasia. JPEN J Parenter Enteral Nutr 4:422

    Google Scholar 

  81. 81.

    Stockeld D, Fageberg J, Granstrom L, Backman L (2001) Percutaneous endoscopic gastrostomy for nutrition in patients with esophageal cancer. Eur J Surg 167:839–844. doi:10.1080/11024150152717670

    Article  CAS  PubMed  Google Scholar 

  82. 82.

    Tagay S, Herpertz S, Langkafel M et al (2006) Health-related quality of life, depression and anxiety in thyroid cancer patients. Qual Life Res 15:695–703. doi:10.1007/s11136-005-3689-7

    Article  PubMed  Google Scholar 

  83. 83.

    Takagi K, Yamamori H, Furukawa K, Miyazaki M et al (2001) Perioperative supplementation of EPA reduces immunosuppression induced by postoperative chemoradiation therapy in patients with esophageal cancer. Nutrition 17:478–479. doi:10.1016/S0899-9007(01)00557-3

    Article  CAS  PubMed  Google Scholar 

  84. 84.

    Takeuchi H, Ikeuchi S, Kawaguchi Y, Kitagawa Y et al (2007) Clinical significance of perioperative immunonutrition for patients with esophageal cancer. World J Surg 31:2160–2167. doi:10.1007/s00268-007-9219-8

    Article  PubMed  Google Scholar 

  85. 85.

    Tang ST (2006) Concordance of quality of life assessments between terminally ill cancer patients and their primary family caregivers in Taiwan. Cancer Nurs 29:49–57. doi:10.1097/00002820-200601000-00009

    Article  PubMed  Google Scholar 

  86. 86.

    Thiel HJ, Fietkau R, Sauer R (1988) Malnutrition and the role of nutritional support for radiation therapy patients. Rec Res Cancer Res 108:205–226

    CAS  Google Scholar 

  87. 87.

    Tyldesley S, Sheehan F, Munk P et al (1996) The use of radiologically placed gastrostomy tubes in head and neck cancer patients receiving radiotherapy. Int J Radiat Oncol Biol Phys 36(5):1205–1209. doi:10.1016/S0360-3016(96)00434-8

    CAS  PubMed  Google Scholar 

  88. 88.

    Van Bokhoerst_De-Van Der Schurer MAE, Quak JJ, Von Blomberg-Van Der Flier BME (2001) Effect of perioperative nutrition with and without arginine supplementation on nutritional status, immune function, postoperative morbidity and survival in severely malnourished head and neck cancer patients. Am J Clin Nutr 73:323–332

    Google Scholar 

  89. 89.

    Weinmann A, Braga M, Haranyi L, Laviano A et al (2006) ESPEN guidelines on enteral nutrition: Surgery including organ transplantation. Clin Nutr 25:224–244. doi:10.1016/j.clnu.2006.01.015

    Article  Google Scholar 

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Bozzetti, F. Nutritional support in patients with oesophageal cancer. Support Care Cancer 18, 41–50 (2010).

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