Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: Results from a randomised trial

Baker, Jannah, Janda, Monika, Graves, Nick, Bauer, Judy, Banks, Merrilyn, Garrett, Andrea, Chetty, Naven, Crandon, Alex J, Land, Russell, Nascimento, Marcelo, Nicklin, James L, Perrin, Lewis C and Obermair, Andreas (2015) Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: Results from a randomised trial. Gynecologic Oncology, 137 3: 516-522. doi:10.1016/j.ygyno.2015.03.048


Author Baker, Jannah
Janda, Monika
Graves, Nick
Bauer, Judy
Banks, Merrilyn
Garrett, Andrea
Chetty, Naven
Crandon, Alex J
Land, Russell
Nascimento, Marcelo
Nicklin, James L
Perrin, Lewis C
Obermair, Andreas
Title Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: Results from a randomised trial
Journal name Gynecologic Oncology   Check publisher's open access policy
ISSN 1095-6859
0090-8258
Publication date 2015-06-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.ygyno.2015.03.048
Open Access Status
Volume 137
Issue 3
Start page 516
End page 522
Total pages 7
Place of publication Maryland Heights, United States
Publisher Academic Press
Language eng
Subject 2729 Obstetrics and Gynaecology
2730 Oncology
Formatted abstract
Background

Malnutrition is common in patients with advanced epithelial ovarian cancer (EOC), and is associated with impaired quality of life (QoL), longer hospital stay and higher risk of treatment-related adverse events. This phase III multi-centre randomised clinical trial tested early enteral feeding versus standard care on postoperative QoL.

Methods

From 2009 to 2013, 109 patients requiring surgery for suspected advanced EOC, moderately to severely malnourished were enrolled at five sites across Queensland and randomised to intervention (n = 53) or control (n = 56) groups. Intervention involved intraoperative nasojejunal tube placement and enteral feeding until adequate oral intake could be maintained. Despite being randomised to intervention, 20 patients did not receive feeds (13 did not receive the feeding tube; 7 had it removed early). Control involved postoperative diet as tolerated. QoL was measured at baseline, 6 weeks postoperatively and 30 days after the third cycle of chemotherapy. The primary outcome measure was the difference in QoL between the intervention and the control group. Secondary endpoints included treatment-related adverse event occurrence, length of stay, postoperative services use, and nutritional status.

Results

Baseline characteristics were comparable between treatment groups. No significant difference in QoL was found between the groups at any time point. There was a trend towards better nutritional status in patients who received the intervention but the differences did not reach statistical significance except for the intention-to-treat analysis at 7 days postoperatively (11.8 intervention vs. 13.8 control, p 0.04).

Conclusion

Early enteral feeding did not significantly improve patients' QoL compared to standard of care but may improve nutritional status.
Keyword Ovarian cancer
Quality of life
Malnutrition
Gynaecological cancer
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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