S00C1 (Berretta) — EDISCIENCES

S00C1

Submission To Be Reviewed

Title: GASTRIC CANCER AND NUTRITIONAL SUPPORT: A binomial which should become dogmatic.

Journal Section

ABSTRACT

INTRODUCTION. The link between cancer and nutrition represents one of the most stimulating topics of scientific research. An important function of nutrition is its modulatory role during oncological treatments and on the patients prognosis. The aim of this article is to investigate this function applying it to gastric cancer and analyzing in particular the effects of nutritional support in the various disease stages. Gastric cancer causes a high rate of malnutrition: it is estimated that the overall malnutrition rate in these patients is between 65 and 85%; nevertheless, nutritional support is struggling to become a routine strategy.

MATERIALS AND TOOLS. For the purpose of this work we decided not to make a systematic review of medical literature on the topic but to provide a summary of the available national and international guidelines, in order to create a practical tool which is useful to clinicians in the management of gastric cancer patients. The main sources are the documents elaborated by the main oncology and clinical nutrition societies. The article development is divided into three paragraphs, which explain respectively malnutrition markers and the modalities of nutritional support, nutritional support in early gastric cancer stages and, finally, in advanced stages.

DISCUSSION AND CONCLUSIONS. Despite the low number and general nature of analyzed issues, mainly due to the multivariable difficulty in performing rigorous studies on the link between nutrition and gastric cancer, the realized work allows us to draw some conclusions: nutritional support is essential in every disease stage and it is important to diversify nutritional approaches according to stage. In early stages the effects of nutritional support are different before and after surgery: in the pre-operative phase the immunostimulating regimens, both orally and artificially, appear to demonstrate a reduction of post-operative complications and hospital stays; in the post-operative phase an early and combined (oral+artificial) nutritional support proved efficacious in improving patient recovery and restoring the natural functions of digestive system. Unfortunately, there is no evidence on the role of nutritional support during perioperative chemotherapy. After hospital discharge, nutritional follow-up is essential and patients should follow the ON indicated by the international guidelines with particular attention to the frequency of meals and to the nutritional supplements. In advanced stages, parenteral nutrition seems to facilitate the start and continuation of chemotherapy, positively affecting patients’ quality of life and survival.

Keywords: gastric cancer, malnutrition, nutritional support.