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Nutrition in acute and chronic diseases

Role of dietitian support in improving weight loss and nutrition impact symptoms after oesophageal cancer surgery

European Journal of Clinical Nutrition volume 75, pages 1134–1141 (2021)Cite this article

Subjects

Abstract

Background

Oesophageal cancer is frequently accompanied with malnutrition. We aimed to evaluate if early support from dietitians and patient’s level of satisfaction with the support from dietitians are associated with better outcomes for weight loss and nutrition impact symptoms (NIS).

Methods

A nationwide and prospective cohort study on patients operated for oesophageal cancer in Sweden from 2013 onwards, included one year after surgery. Study exposures were (1) preoperative dietitian support (yes vs no) and, (2) patient reported satisfaction with dietitian support (high vs low) and outcomes were postoperative (1) percentage weight loss and (2) NIS score (range 0–24); one year after surgery. An ANCOVA model adjusted for predefined confounders was used and presented as mean differences (MD) with 95% confidence intervals (CI).

Results

Among 245 patients, as many as 57% had received preoperative dietitian support. Preoperative dietitian support was not associated with statistically significant differences in mean postoperative weight loss (MD 0.2 [95% CI −2.6 to 2.9]) and mean NIS score (MD 0.1 [95% CI: −0.8 to 1.0]). Likewise, satisfaction with the dietitian support was not associated with significant differences in mean postoperative weight loss (MD 1.4 [95% CI: −1.5 to 4.3]) and NIS score (MD −0.1 [95% CI: −1 to 0.8]).

Conclusions

Long-term postoperative weight loss and NIS were not influenced based on whether dietitian support was initiated preoperatively or not and patient’s satisfaction level with dietitian support. Similarity in results may reflect effective screening of malnutrition and dietitian support in centres treating oesophageal cancer in Sweden.

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Fig. 1: Comparison of outcomes of patient reported satisfaction with dietitian contact as per sensitivity analysis.

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Funding

The Swedish Research Council (grant number 521-2012-2824), the Swedish Cancer Society (grant number 180685), Avtal om Läkarutbildning och Forskning (grant number ALF: LS 2018-1157), The Cancer Research Foundations of Radiumhemmet (grant number 171103).

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Authors and Affiliations

  1. Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 171 77, Stockholm, Sweden

    Poorna Anandavadivelan, Kalle Mälberg, Helen Rosenlund, Asif Johar & Pernilla Lagergren

  2. Reproductive Health, Department of Women’s and Children’s Health, Uppsala University, 751 85, Uppsala, Sweden

    Anna Wikman

  3. Division of Clinical Nutrition and Dietetics, Department of Orthopedics, Danderyd Hospital, 182 88, Stockholm, Sweden

    Helen Rosenlund

  4. Department of Surgery and Cancer, Imperial College London, SW7 2AZ, London, UK

    Pernilla Lagergren

Authors
  1. Poorna Anandavadivelan
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  2. Anna Wikman
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  3. Kalle Mälberg
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  4. Helen Rosenlund
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  5. Asif Johar
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  6. Pernilla Lagergren
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Contributions

PL conceived and planned the project and developed methods for data collection and is the principal investigators of the project. PA, AW, KM, HR, AJ and PL participated in study design. AJ conducted the statistical analysis. All authors contributed to the refinement of the manuscript and approved the final manuscript.

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Correspondence to Poorna Anandavadivelan.

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The authors declare that they have no conflict of interest

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Anandavadivelan, P., Wikman, A., Mälberg, K. et al. Role of dietitian support in improving weight loss and nutrition impact symptoms after oesophageal cancer surgery. Eur J Clin Nutr 75, 1134–1141 (2021). https://doi.org/10.1038/s41430-020-00830-0

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