Nutrition and Cancer-An International Journal最新文献

Objective: This study aimed to evaluate the efficacy of a double-lumen biliary-enteric tube (DBET) for enteral nutrition (EN) in individuals with malignant obstructive jaundice (MOJ).

Methods: A retrospective cohort study was conducted using data from a prospectively maintained single-center database, including patients with MOJ. In the intervention group, DBET placement was performed concurrently with percutaneous transhepatic cholangiodrainage and biliary stenting, followed by postoperative EN (DBET-EN). In the control group, deep vein catheterization was undertaken after endoscopic biliary stenting, and parenteral nutrition (PN) was provided. A multivariable generalized linear model was used to assess the association between DBET-EN and 6-month mortality.

Results: A total of 74 patients were included in this study, comprising 28 patients in the intervention group (DBET-EN group) and 46 patients in the control group (PN group). Within the 6-month follow-up, 5 patients (17.9%) in the DBET-EN group and 20 (43.5%) in the PN group died. The multivariable generalized linear model demonstrated a significantly reduced 6-month mortality in the DBET-EN group compared to the PN group (adjusted odds ratio [OR]: 0.25, 95% CI: 0.08-0.81, P = 0.020). Secondary outcomes indicated that patients in the DBET-EN group had lower 9-month mortality rates and longer tube retention durations compared to the PN group (all adjusted P < 0.05). Postoperative liver function improved similarly in both groups. At 3, 6, and 9 months postoperatively, patient-generated subjective global assessment (PG-SGA) scores and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) scores were significantly higher in the DBET-EN group than in the PN group (P < 0.05).

Conclusion: The implementation of DBET for EN in patients in the advanced stage of MOJ proved to be a minimally invasive and safe intervention. It significantly improved patients' nutritional status and quality of life while reducing mortality.

Data supporting the safety and clinical efficacy of early oral feeding (EOF) after total gastrectomy are limited. The aim of this prospective randomized controlled study was to explore the safety and clinical efficacy of two early enteral nutrition approaches for gastric cancer patients after radical total gastrectomy. The EOF group had faster postoperative recovery of intestinal function than the enteral tube feeding (ETF) group. The times to first flatus and first defecation were shorter in the EOF group (p < 0.05). In addition, the EOF protocol effectively avoided abdominal distension (p < 0.05). The hospitalization cost of the EOF group was lower than that of the ETF group (p < 0.05). Moreover, oral nutrition satisfied the physiological need for oral intake. People were more satisfied with EOF (p < 0.01). Furthermore, it is worth noting that compared with ETF, EOF did not increase the risk of anastomotic complications such as leakage and bleeding. Most obviously, EOF not only avoided the risk of complications during tube insertion, but also avoided the discomfort experience of nasal feeding tube. In summary, compared with ETF, EOF promotes early bowel recovery effectively without increasing the risk of postoperative complications. It is safe and comfortable for gastric cancer patients undergoing radical total gastrectomy.

Gastric cancer (GC) is a malignant tumor with high morbidity and mortality rates worldwide. This study aimed to investigate the effects and mechanisms of action of didymin, a dietary flavonoid glycoside, on GC treatment. Human GC cell lines Hs-746T and AGS were used to assess the effects of didymin on cell viability, cell proliferation, and cell cycle. The results showed that didymin decreased the proliferative capacity of GC cells and blocked cell cycle. Didymin decreased wound healing, invasion, and migration capacities of GC cells. Mitochondrial reactive oxygen species (ROS) levels and mitochondrial membrane potentials were reduced in cells treated with didymin. Network pharmacology analysis revealed that the therapeutic effects of didymin on AGS cells were related to the phosphatidylinositol 3-kinase (PI3K)/Akt pathway. In vivo mouse xenograft studies confirmed that didymin treatment decreased tumor cell proliferation, cell cycle protein levels, and Akt phosphorylation. The present study demonstrated that didymin regulates mitochondrial function and the PI3K/Akt pathway to inhibit cell proliferation and induce apoptosis in GC cells in vitro and in vivo. Therefore, didymin is a promising drug for the treatment of GC.

Background: Breast cancer patients are at risk of acute decompensated heart failure (ADHF) and protein-energy malnutrition (PEM) due to chemoradiation effects or cancer itself. There are no existing studies on the impact of PEM on breast cancer patients hospitalized for ADHF. This study aims to evaluate the effects of PEM on breast cancer patients admitted for ADHF.

Methods: Using the 2020 US National Inpatient Sample (NIS), our study analyzed breast cancer patients aged 18 and older. A multivariate logistic and linear regression analysis determined the odds ratio for various outcomes. The primary outcome was inpatient mortality among patients hospitalized for ADHF based on the presence or absence of PEM, while secondary outcomes included cardiogenic shock, anemia, and total hospital charges.

Results: Thirty thousand five hundred and fifty-five (30,555) patients were identified, predominantly female (99%) and Caucasian (71.4%). Among them, 6.07% were diagnosed with concurrent PEM. PEM was associated with higher in-hospital mortality risk (aOR 2.61), increased cardiogenic shock (aOR 3.17), anemia (aOR 1.43), more extended hospital stays (b 2.09), and higher hospital charges (average $28,285).

Conclusions: The findings indicate that comorbid PEM is associated with increased risks of in-hospital mortality, anemia, cardiogenic shock, prolonged hospital stays and increased overall hospital costs among breast cancer patients admitted for ADHF.

High sodium diets have been shown to promote stomach colonization and the induction of tissue damage by Helicobacter pylori (H. pylori), a risk factor for gastric cancer. Among American Indians in the Southwest, where the H. pylori prevalence is 60%, the association between diet and H. pylori infection has not been studied. We conducted a cross-sectional pilot study with 93 adults (51%, 18-44 years, 73% female) in the Navajo Nation to assess their diet with self-administered food questionnaires and to detect H. pylori from stool samples using droplet digital PCR. Three diet patterns were identified using Principal Component Analysis: 1) Western, 2) Soups and Mixed Dishes, and 3) Fruits and Vegetables. Participants in the highest and middle tertiles of the Soups and Mixed Dishes pattern scores had higher odds of having H. pylori (OR_Highest=5.59, 95% CI, 1.50-23.70; OR_Middle=3.48, 95% CI, 1.08-12.32) than those in the lowest tertile. This positive association may be linked to the sodium content of foods in this diet pattern. Soups and Mixed Dishes may contribute to H. pylori infection and may be incorporated in nutrition education for individuals positive for H. pylori infection in the Navajo Nation.

Older cancer patients present a high risk of malnutrition and muscle loss, which can worsen outcomes and delay recovery. This study assessed whether combining nutritional risk screening tools with calf circumference (CC) measurements improves the prediction of hospital outcomes in older adults with solid tumors. A secondary analysis of 305 hospitalized cancer patients (mean age 68.2 ± 8.9 years; 59.3% male; 32.8% with gastrointestinal cancers) was conducted. Low CC was defined as ≤34 cm for men and ≤33 cm for women, with adjustments for body mass index ≥ 25 kg/m². Nearly 60% of patients had low CC. The Mini Nutritional Assessment-Short Form, particularly when combined with low unadjusted CC, showed the highest accuracy and sensitivity among the screening tools for predicting hospital stays of five days or more. In adjusted analyses, patients identified as being at nutritional risk and presented with low CC had approximately twice the odds of experiencing prolonged hospitalization. No significant association was found with hospital readmissions. These findings underscore the importance of integrating anthropometric measures like CC with established nutritional screening tools to better identify older cancer patients at risk for extended hospital stays.

The SARS-CoV-2 virus has been the subject of study by several researchers worldwide since 2020; however, there are points to be clarified. This study aimed to analyze the clinical and nutritional aspects of hospitalized cancer and non-cancer pediatric patients and the association with COVID-19 outcomes. This is a cohort study of hospitalized children and adolescents with a laboratory diagnosis of COVID-19. Patients were assessed according to the presence or absence of previous oncological diseases. Sociodemographic, clinical and nutritional data were investigated during the course of the infection. Outcomes included Intensive Care Unit (ICU) admission, longer length of stay (14 days), criticality, and death. Oncological disease was found in 16 (19.3%) patients, most of whom had B-type acute lymphoid leukemia. In Poisson regression, adjusted for age and comorbidity, an association was found between oncological disease and length of stay ≥14 days (RR 4.30; 95% CI 1.46 - 15.6; p = 0.013), COVID-19 criticality (RR 3.82; 95% CI 1.66 - 30.9; p = 0.010) and death (RR 3.42; 95% CI 0.94 - 9.96; p = 0.035). The research revealed that cancer patients had longer hospital stays, were more likely to have the severe form of COVID-19, and had a 3.42 times greater risk of dying.

Background: Colorectal cancer (CRC) is a prevalent global malignancy with substantial morbidity and mortality. Accurate prognostic evaluation is essential in CRC patient management. This study investigates the prognostic significance of red blood cell count (RBC) and Onodera's prognostic nutritional index (OPNI) in resectable CRC patients.

Methods: A retrospective analysis of 210 CRC patients undergoing radical resection (January 2015-January 2017) assessed clinical and hematological factors, including RBC, albumin, hemoglobin, and OPNI. A novel comprehensive biomarker, R-OPNI, combining preoperative RBC with OPNI, was introduced. Correlations with patient survival were analyzed, and R-OPNI's independent prognostic value was assessed through univariate and multivariate Cox models. Predictive ability was compared to other factors using the receiver operating characteristic (ROC) method.

Results: Higher RBC levels (≥ 3.9 × 10¹²/L) and elevated OPNI were associated with significantly improved overall survival. Lower R-OPNI scores (0 or 1) indicated notably poorer survival. Multivariate analysis confirmed R-OPNI's independent prognostic significance (HR: 0.273, 95% CI: 0.098-0.763, p = 0.013). R-OPNI (AUC = 0.732) demonstrated superior predictive value compared to individual prognostic factors.

Conclusion: R-OPNI emerges as a robust, independent prognostic predictor for resectable CRC patients, emphasizing the importance of assessing preoperative nutritional status.

There is inconclusive evidence on the role of dietary intake of vitamin B₁₂ in cancer. We evaluated the association between vitamin B₁₂ intake and cancer risk in a hospital-based case-control study, comprising 3,758 cancer cases and 2,995 controls in Vietnam. Vitamin B₁₂ intake was derived from the validated food frequency questionnaire. Unconditional logistic regression model was used to calculate the odds ratios (ORs), and respective 95% confidence intervals (CIs) for the association between vitamin B₁₂ and cancer risk. There was a U-shaped association between vitamin B₁₂ intake and overall risk of cancer. Individuals with intakes lower than the median intake had a 6% (OR = 1.06, 95% CI: 0.86-1.31)-107% (OR = 2.07, 95% CI: 1.58-2.71), increased risk of cancer (P_trend<0.001), whereas those with higher intakes than the median intake had a 20% (OR = 1.20, 95% CI: 0.97-1.48)-52% (OR = 1.52, 95% CI: 1.22-1.89) increased risk of cancer (P_trend<0.04). The excess risk of cancer associated with low intakes of vitamin B₁₂ was observed among esophageal, lung, and breast cancer patients, whereas with high intakes of vitamin B₁₂ among gastric cancer patients. In summary, a U-shaped association between vitamin B₁₂ intake and increased cancer risk was observed in the Vietnamese population.