Effect of Nutritional Support as an Adjunct to the Treatment of Esophageal Cancer

Abstract

The physical appearance of patients with cancer of the esophagus frequently gives evidence of serious nutritional deficit. Almost all patients with esophageal cancer show protein-calorie malnutrition (PCM) on admission, due to the physical effects of the narrowing of esophageal lumen, consumption of body protein by tumor, and anorexia. These factors contribute to specific macro- and micronutrient deficits, leading to malnutrition [1]. When malnourished patients with esophageal cancer have undergone surgery, their nutritional status and immunity are further aggravated by surgical intervention or the limitation of caloric intake due to postoperative fasting [2]. As a result, postoperative complications such as infection, respiratory complication, and wound dehiscence easily occur. At present, nutritional replenishment with total parenteral nutritional (TPN) or enteral nutrition (EN) cannot only reverse PCM, but can also restore immunocompetence [3, 4]. On the other hand, patients with advanced esophageal cancer can be given sufficient anti-cancer treatment, supported by the nutritional therapy [5]. We studied nutritional assessment by measuring various nutritional parameters in patients with esophageal cancer and the correlation between preoperative nutritional assessment and incidence of postoperative complications. Further studies were performed on the effect of nutritional support by TPN at the time of preoperative radiation therapy on nutritional status and tumor response.