PD41-04 ORAL NUTRITION INTERVENTION IN PATIENTS UNDERGOING RADICAL CYSTECTOMY: A PROSPECTIVE, RANDOMIZED CONTROLLED TRIAL

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive V1 Apr 2018PD41-04 ORAL NUTRITION INTERVENTION IN PATIENTS UNDERGOING RADICAL CYSTECTOMY: A PROSPECTIVE, RANDOMIZED CONTROLLED TRIAL Chad Ritch, James Thu, Veronica Ralls, Kareem Fakhoury, David Penson, Sam Chang, Joseph Smith Jr, Peter Clark, Michael Cookson, and Heidi Silver Chad RitchChad Ritch More articles by this author , James ThuJames Thu More articles by this author , Veronica RallsVeronica Ralls More articles by this author , Kareem FakhouryKareem Fakhoury More articles by this author , David PensonDavid Penson More articles by this author , Sam ChangSam Chang More articles by this author , Joseph Smith JrJoseph Smith Jr More articles by this author , Peter ClarkPeter Clark More articles by this author , Michael CooksonMichael Cookson More articles by this author , and Heidi SilverHeidi Silver More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1943AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nutrition status is a predictor of clinical outcome following radical cystectomy (RC). We designed a prospective, randomized controlled trial to assess the impact of an enriched, high protein oral nutrition supplement (ONS) on nutrition status and clinical outcome following RC. METHODS 61 patients were randomized to receive either ONS (Group 1) or multivitamin (MV) control (Group 2). Both ONS and MV were administered twice daily for 2 weeks before and 4 weeks after RC. All patients received a standardized post-operative clinical care pathway. Data were collected on standard demographic and clinical variables. Post-operative complications were assessed using the Clavien-Dindo classification. The primary endpoint was 30d hospital free days (HFDs), calculated using the formula: 30 - (length of stay (LOS) + LOS readmission). Secondary endpoints included: change from baseline nutrition status as measured by skeletal muscle index (SMI), to assess for sarcopenia, on CT imaging (Slice-O-Matic V4.0, Tomovision, Canada), as well as LOS, readmission rate, complication rate and grade. Statistical analysis was performed to compare primary and secondary endpoints. RESULTS There were 31 patients in Group 1, and 30 patients in Group 2. All were included in the final analysis. There were no significant differences with respect to age, comorbidity and performance status between groups. The groups were also similar with respect to treatment approach and clinicopathologic features. The complication rate was lower in Group 1 compared to Group 2, but this was not statistically significant (39% vs 43%). There were fewer grade 3 or 4 complications in the Group 1 versus Group 2 (18% vs 39%) but this was not statistically significant. The median 30d HFDs and LOS was similar between groups (24 vs 25 and 7 vs 6.5 days). Of those with normal SMI at baseline, there were significantly fewer patients who developed sarcopenia and sarcopenic obesity following RC in Group 1 compared to Group 2 (sarcopenia: 57% vs 66%, p<0.05; sarcopenic obesity 7% vs 31%, p<0.05). CONCLUSIONS RC patients undergoing nutrition intervention are significantly less likely to have a decline in nutrition status following surgery, as measured by sarcopenia and sarcopenic obesity. Supplemented patients may have fewer, and less severe, complications following RC but we did not have sufficient power to demonstrate a significant difference. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e810 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Chad Ritch More articles by this author James Thu More articles by this author Veronica Ralls More articles by this author Kareem Fakhoury More articles by this author David Penson More articles by this author Sam Chang More articles by this author Joseph Smith Jr More articles by this author Peter Clark More articles by this author Michael Cookson More articles by this author Heidi Silver More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...