The Effectiveness of Nutrition Interventions Combined with Exercise in Upper Gastrointestinal Cancers: A Systematic Review.

Suzanne L. Doyle,Juliette Hussey,Emer M. Guinan,David Mockler,Fatemeh Sadeghi

doi:10.3390/nu13082842

Suzanne L. Doyle, Juliette Hussey + Show 3 more

Open Access

https://doi.org/10.3390/nu13082842

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Abstract

Malnutrition and muscle wasting are associated with impaired physical functioning and quality of life in oncology patients. Patients diagnosed with upper gastrointestinal (GI) cancers are considered at high risk of malnutrition and impaired function. Due to continuous improvement in upper GI cancer survival rates, there has been an increased focus on multimodal interventions aimed at minimizing the adverse effects of cancer treatments and enhancing survivors’ quality of life. The present study aimed to evaluate the effectiveness of combined nutritional and exercise interventions in improving muscle wasting, physical functioning, and quality of life in patients with upper GI cancer. A comprehensive search was conducted in MEDLINE, EMBASE, Web of Science, Cochrane Library, and CINHAL. Of the 4780 identified articles, 148 were selected for full-text review, of which 5 studies met the inclusion criteria. Whilst reviewed studies showed promising effects of multimodal interventions on physical functioning, no significant differences in postoperative complications and hospital stay were observed. Limited available evidence showed conflicting results regarding the effectiveness of these interventions on preserving muscle mass and improving health-related quality of life. Further studies examining the impact of nutrition and exercise interventions on upper GI patient outcomes are required and would benefit from reporting a core outcome set.

Highlights

Upper GI cancers, namely esophageal cancer, gastric cancer, hepatobiliary cancers, and pancreatic cancer, were reported to affect 3.12 million individuals (17.3% of the global cancer incidence) in 2018 [1]
This systematic review describes the effectiveness of multidisciplinary programs, whose core component was nutritional and exercise interventions, in improving outcomes in patients diagnosed with upper GI cancers
Limited evidence is available on the effectiveness of multimodal interventions, with a core component of nutrition and exercise, in improving outcomes in upper GI cancer patients

Summary

Introduction

Upper GI cancers, namely esophageal cancer, gastric cancer, hepatobiliary cancers, and pancreatic cancer, were reported to affect 3.12 million individuals (17.3% of the global cancer incidence) in 2018 [1]. The treatment for upper GI cancer includes surgery, chemotherapy, and radiotherapy. Advances in these cancer treatments, and early cancer diagnosis, has led to higher survival rates, the treatments are accompanied by adverse effects on patients’ nutritional status and physical function [2,3,4,5,6]. Muscle wasting is accompanied by reduced physical function, fatigue, chemotherapy toxicity, lower quality of life, and a higher rate of postoperative complications [7,8,9,10]. Due to the tumor location and the unique influences of curative surgery on a patient’s dietary intake, patients with upper GI cancer are at a greater risk of malnutrition and its related complications [11,12,13].

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