Randomized clinical trial of omega-3 fatty acid-supplemented enteral nutrition versus standard enteral nutrition in patients undergoing oesophagogastric cancer surgery.
Study Goal
The researchers aimed to assess whether perioperative omega-3 fatty acids (O-3FAs) could modulate immune function and improve clinical outcomes in patients undergoing oesophagogastric cancer surgery.
Results Summary
The study found that while O-3FA supplementation significantly increased plasma concentrations, it did not affect immune function (HLA-DR expression) or clinical outcomes (morbidity, mortality, hospital stay) compared to standard nutrition or control groups.
Population
Patients undergoing subtotal oesophagectomy and total gastrectomy for oesophagogastric cancer.
Effective Dosage
Not specified (enteral immunoenhancing diet for 7 days pre- and post-surgery).
Duration
7 days before and after surgery.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
omega-3 fatty acid enteral immunoenhancing diet | increase | O-3FA concentrations | patients undergoing subtotal oesophagectomy and total gastrectomy | P < 0.001 | were higher | #1 |
omega-3 fatty acid enteral immunoenhancing diet | no change | overall HLA-DR expression on leucocytes | patients undergoing oesophagogastric cancer surgery | - | did not affect | #2 |
omega-3 fatty acid enteral immunoenhancing diet | no change | clinical outcome | patients undergoing oesophagogastric cancer surgery | - | did not affect | #3 |
omega-3 fatty acid enteral immunoenhancing diet | no change | morbidity | patients undergoing subtotal oesophagectomy and total gastrectomy | P = 0.646 | no differences | #4 |
omega-3 fatty acid enteral immunoenhancing diet | no change | mortality | patients undergoing subtotal oesophagectomy and total gastrectomy | P = 1.000 | no differences | #5 |
omega-3 fatty acid enteral immunoenhancing diet | no change | hospital stay | patients undergoing subtotal oesophagectomy and total gastrectomy | P = 0.701 | no differences | #6 |
omega-3 fatty acid enteral immunoenhancing diet | no change | HLA-DR expression in monocytes | patients undergoing subtotal oesophagectomy and total gastrectomy | P = 0.538 | no differences | #7 |
omega-3 fatty acid enteral immunoenhancing diet | no change | HLA-DR expression in activated T lymphocytes | patients undergoing subtotal oesophagectomy and total gastrectomy | P = 0.204 | no differences | #8 |
BACKGROUND: Oesophagogastric cancer surgery is immunosuppressive. This may be modulated by omega-3 fatty acids (O-3FAs). The aim of this study was to assess the effect of perioperative O-3FAs on clinical outcome and immune function after oesophagogastric cancer surgery. METHODS: Patients undergoing subtotal oesophagectomy and total gastrectomy were recruited and allocated randomly to an O-3FA enteral immunoenhancing diet (IED) or standard enteral nutrition (SEN) for 7 days before and after surgery, or to postoperative supplementation alone (control group). Clinical outcome, fatty acid concentrations, and HLA-DR expression on monocytes and activated T lymphocytes were determined before and after operation. RESULTS: Of 221 patients recruited, 26 were excluded. Groups (IED, 66; SEN, 63; control, 66) were matched for age, malnutrition and co-morbidity. There were no differences in morbidity (P = 0·646), mortality (P = 1·000) or hospital stay (P = 0·701) between the groups. O-3FA concentrations were higher in the IED group after supplementation (P < 0·001). The ratio of omega-6 fatty acid to O-3FA was 1·9:1, 4·1:1 and 4·8:1 on the day before surgery in the IED, SEN and control groups (P < 0·001). There were no differences between the groups in HLA-DR expression in either monocytes (P = 0·538) or activated T lymphocytes (P = 0·204). CONCLUSION: Despite a significant increase in plasma concentrations of O-3FA, immunonutrition with O-3FA did not affect overall HLA-DR expression on leucocytes or clinical outcome following oesophagogastric cancer surgery. REGISTRATION NUMBER: ISRCTN43730758 (http://www.controlled-trials.com).