Aim
The primary aim of this study was to investigate the nutritional outcome of patients with oesophageal cancer. The secondary aim was to identify patient’s characteristics that were associated with weight loss.
Methodology
All patients who were diagnosed with oesophageal and GOJ cancer and had received chemotherapy and/or radiation therapy treatment at the LCTC between 1st August 2010 to 28th February 2014 were included in this retrospective study. Nutrition and clinical outcomes were collected.
Result
A total of 69 patients met the inclusion criteria. The median weight loss prior to treatment commenced was 10.5% (IQR 8.8%). This confirmed that oesophageal cancer patients were at high nutritional risk at diagnosis. The decline of nutritional status continued throughout their treatment. Curative patients have a higher median percentage of weight loss than those for palliation during treatment (4.64%, IQR=6.36% vs 3.01%, IQR=5.04%, p=0.054). Invasive nutritional intervention was required in 7 and 19 patients with a feeding tube or stent inserted respectively. Of patients treated with curative intent radiotherapy, all who had a nasogastric tube insertion completed radiotherapy as compared to 80% who had a stent insertion. Eighty precent of curative patients with a stent insertion (80%) required hospital admission. Due to the small sample size, it was difficult to compare the effectiveness of these two methods. More than 30% of the patients have lost more than 5% weight per month. There was a higher percentage of patients from culturally and linguistically diverse background (CALD) having significant weight loss than their counterpart (p=0.044).
ConclusionOesophageal cancer patients are at high nutritional risk and commonly present with significant weight loss during their treatment. Stents can potentially result in a higher complication rate. A standardised protocol of nutrition management for oesophageal cancer patients is recommended. A focus should be on assisting patients with CALD background.