Outcomes of Parenteral Nutrition in Patients with Advanced Cancer and Malignant Bowel Obstruction

Overview

Journal Res Sq

Date 2023 Nov 28

PMID 38014195

Authors

David A Velasquez

Ankit Dhiman

Colette Brottman

Oliver S Eng

Emily Fenton

Jean Herlitz

Edward Lozano

Edwin McDonald

Valerie Reynolds

Elizabeth Wall

Jeffrey Whitridge

Carol Semrad

Kiran Turaga

Dejan Micic

Affiliations

Soon will be listed here.

Abstract

Background: Malignant bowel obstruction (MBO) affects 3-15% of all cancer patients. In patients with advanced cancer and inoperable MBO, the average survival varies between four to nine weeks. Parenteral nutrition (PN) may improve survival in specific patient populations with malignant bowel obstruction.

Aims: This retrospective, single-center cohort study aimed to review individual patient outcomes on PN in the setting of advanced cancer with a diagnosis of MBO and identify clinical and laboratory markers predictive of short- and long-term survival to further highlight patients that would benefit from PN in the setting of an inoperable MBO.

Results: In a retrospective analysis of 68 patients receiving PN for inoperable MBO, the median survival was 142 (IQR: 63.3-239.5) days. Patients experienced a median number of two hospital readmissions (range: 0-10) and spent a median of 29 days (range: 0-105) in the hospital after starting PN. Eighteen (26.5%) patients developed a catheter-related bloodstream infection (CRBSI). A diagnosis of appendiceal cancer was identified as a predictive marker of improved survival (HR: 0.53, 95% CI: 0.29-0.92, p = 0.023).

Conclusions: The use of PN in the context of end-of-life cancer care is a practice that necessitates improvement. Recognizing the outcomes and patient experiences of PN utilization is essential to physicians and patients.

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