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Perioperative immunonutrition in head and neck cancer
Author(s) -
Sorensen LTC Douglas,
McCarthy Mary,
Baumgartner MAJ Brian,
Demars CPT Sean
Publication year - 2009
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20494
Subject(s) - medicine , perioperative , surgery , head and neck cancer , lymphocyte , immune system , wound healing , gastroenterology , cd8 , cancer , immunology
Objectives/Hypothesis: Immune‐modulating nutrition (IMN) support before and after surgery has the potential to promote host defense, antitumor activities, and wound healing. The purpose of this study was to examine the nutritional, immunologic, and wound healing outcomes in patients receiving IMN versus standard formula. Study Design: A prospective, blinded, randomized design was used for this study. Fifteen patients with head and neck squamous cell carcinoma received either an IMN formula (treatment group) or a standard stress formula (relative comparison group [RCG]) for a period of 7 days pre‐ and postoperatively. Methods: Albumin and prealbumin were measured at baseline, day of surgery (DOS), and postoperative day (POD) 1, 4, and 8. Immunologic outcomes included C‐reactive protein and total lymphocyte count with lymphocyte subset counts (CD3, CD4, CD8, CD4:8 ratio, CD19, CD56) at baseline, DOS, POD1, 4, and 8. Cell‐mediated immunity was evaluated by delayed‐type hypersensitivity. Wound healing was assessed using the ASEPSIS tool. Results: CD3+ and CD4+ T cells demonstrated a significant difference between groups on POD 1 ( P = .03 for both) and CD56 NK cells on POD 8 ( P = .04). In general, wounds healed without complications except for tracheoesophageal fistula development in two patients in the RCG. Conclusions: A trend toward less immune suppression in patients receiving IMN is supported in this study. Laryngoscope, 2009