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Potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial



This study aimed to test whether a very early nutrition intervention delivered over the telephone was feasible and could improve outcomes amongst patients with upper gastrointestinal cancer.


Participants with a histologically proven new diagnosis of primary oesophageal or stomach cancer and who were to undergo surgery and/or chemotherapy were randomised to receive either standard nutrition care (SC) or early and intensive nutrition intervention (NI) over the telephone/face-to-face. Participants were followed for 6 months. The primary outcome was quality of life (QoL), assessed using the European Organization for Research and Treatment of Cancer Global Quality of Life questionnaire C30 (EORTC QLQ-C30) and the European Quality of Life Instrument (EQ-5D) tool; secondary outcomes were nutritional status and survival.


Twenty-one participants were recruited (11 SC and 10 NI). At baseline, the prevalence of malnutrition was 90 %. Compared with SC, the NI group had a significantly higher EORTC global QoL score at the first mid-study follow-up (coefficient (95 % CI) 21.0 (12.1, 29.9) adjusted for baseline, p < 0.001) and at 26 weeks (28.4 (21.3, 35.4) adjusted for baseline, p < 0.001). Nutritional risk score was lower (p < 0.001), and loss of body weight attenuated (p < 0.001) in the NI group compared with SC. Six deaths occurred during the study, five in the SC group and one in the NI group (p = 0.06). The mean time spent with a dietitian per contact was significantly less for the NI group compared with SC (16(3) vs 40(6) min per dietetic contact, p < 0.001).


This pilot study has shown the potential of a novel telephone-based early and intensive dietetic model of care for newly diagnosed upper gastrointestinal cancer patients.

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The authors would like to thank (1) Liang Low, Paul Cashin, John Gribbin and the Upper Gastrointestinal consultants of Monash Health for their contribution to recruiting patients to this study; (2) Carmen Puskas for data entry; (3) Southern Melbourne Integrated Cancer Service for funding.

Conflict of interest

None of the authors have a conflict of interest to declare. This work was funded by Southern Melbourne Integrated Cancer Service (SMICS).

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Correspondence to Mary Anne Silvers.

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All authors have made substantial contributions and final approval of the conceptions, drafting and final version.

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Silvers, M.A., Savva, J., Huggins, C.E. et al. Potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial. Support Care Cancer 22, 3035–3044 (2014).

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  • Dietetics
  • Oesophageal cancer
  • Stomach cancer
  • Quality of life