Use of total parenteral nutrition (TPN) in terminally ill gastrointestinal (GI) cancer patients (pts) compared to other malignancies (OM): A single-institution experience.

Abstract

309 Background: TPN is increasingly used in terminally ill cancer patients. The purpose of this study is to determine the validity of TPN in terminally ill GI cancer patients compared to OM. Methods: Cancer pts with limited life expectancy were given TPN between 2007 and 2012. Patients had advanced stage cancer with inoperable non-functional GI tract or failure to thrive. The primary outcome was survival from time of initiating TPN. Results: 89 pts were started on TPN (57 with GI cancer and 32 with OM). The majority of OM were GYN cancer. The mean age was 56 in the GI group vs. 58 in the OM. 47% of all patients underwent treatment while on TPN. The median duration of TPN was 38 days (39 days in the GI group vs. 52 days in the OM group). The median time from TPN to death was 70 days (55 days in the GI group vs. 77 days in the MO group). 14 patients had restored bowel function. 3 patients are living and only one is on TPN. 26 pts required palliative gastrostomy tube. TPN complication was high with 68% of pts requiring readmission, many were admitted several times. Conclusions: Terminal cancer patients receiving TPN had a median survival of 70 days; survival was shorter in the GI cancer group. Quality of life did not improve in the majority of patients; nor did it influence ultimate outcome. These data, thus, raise the question of the validity of the use of TPN in terminally ill pts.