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- Title
Malnourishment in bladder cancer and the role of immunonutrition at the time of cystectomy: an overview for urologists.
- Authors
Munbauhal, Gavish; Drouin, Sarah J.; Mozer, Pierre; Colin, Pierre; Phé, Véronique; Cussenot, Olivier; Rouprêt, Morgan
- Abstract
The 'gold standard' treatment for patients with carcinoma invading the bladder muscle is radical cystectomy ( RC). Such patients are known to be at risk of malnutrition because of age and disease factors. Current evidence has established the nutritional and immunological benefits of immune-enhancing nutritional supplements in upper gastrointestinal surgery. There are currently no guidelines for immunonutrition ( IM) use in urology and bladder cancer specifically., We carried out a systematic review of the available literature in the MEDLINE/Embase database. We assessed the rates of malnutrition in RC cohorts and analysed the clinical impacts of nutritional deficiency. The impact of immune-enhancing supplements was also investigated in RC cohorts with regard to postoperative outcomes., The prevalence of severe malnutrition was found to be 16-22%. There was a consistent association of malnourished patients with adverse postoperative outcomes in terms of mortality and morbidity. There is a paucity of data regarding IM in urological cohorts. Postoperative IM in RC was not found to have significant benefits beyond early return to a normal diet., There is not enough evidence in malnourished urological study cohorts to establish a consensus on IM. Until there are more well-controlled comparative effective studies or randomized trials, the role of IM should be considered investigational in patients with bladder cancer.
- Subjects
BLADDER cancer; CYSTECTOMY; MALNUTRITION; GASTROINTESTINAL surgery; MEDICAL literature
- Publication
BJU International, 2014, Vol 114, Issue 2, p177
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/bju.12529