Nutrition counselling as an integral part of the treatment strategy among cancer patients with gastric tumor resection

Peer reviewed / Manuscript (original) submitted: 10 December 2020 / Revision accepted: 28 June 2021

Investigation of the status quo

Prevalence of malnutrition in cancer patients is highest among patients diagnosed with gastric cancer [1–5]. According to a prevalence study with 1,677 patients, 48% of cancer patients with a tumor in the upper gastrointestinal tract were malnourished [1]. A recently published retrospective cohort study among 131 patients with advanced gastric cancer receiving first-line systemic chemotherapy confirms this estimation and showed that up to 53% experienced weight loss within the first 12 weeks but increased to 88% after 48 weeks [4].

While pre-operative conditioning programs have been established and well accepted among the surgical community, follow up care among cancer patients who underwent gastric resection is often overlooked. Guidelines strongly recommend both pre- and postoperative nutritional risk assessment and provision of nutrition care for patients at risk of malnutrition before and after an extensive surgery [6]. Furthermore, experts recommend that all cancer patients continue to receive nutrition counselling in order to improve or maintain the nutritional status throughout the continuum of care [7]. Thus, our survey aimed to investigate the status quo of the availability and perception of nutrition counselling and the need for nutrition intervention among patients who underwent gastric tumor resection and thereby gain insights that could potentially lead to future prospective intervention trials in this population. ...

Abstract

Background: Malnutrition is widespread among patients with gastric cancer undergoing surgery. Experts recommend addressing nutritional needs of cancer patients pre- and postoperative.
Methods: A structured questionnaire was sent to stomach cancer support groups across Germany. It contained questions regarding the utilization and perception of nutrition counselling as well as the Patient-Generated Subjective Global Assessment (PG-SGA).
Results: 39 respondents (81%) received nutrition counselling at any point after diagnosis, in particular during the rehabilitation phase. More than half of the patients who received counselling (56%) were not fully able to implement the dietary advice provided. According to the PG-SGA, 24 out of 46 respondents (52%) required nutrition intervention, despite the fact that many received their surgery over a year ago.
Conclusion: The results of the survey indicate the need for a more patient- centered concept in which early and continuous nutrition care is delivered by qualified professionals and adjusted to the patient’s individual needs.

Keywords: gastric cancer, gastric resection, malnutrition, nutrition counselling, PG-SGA

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