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Preoperative Nutritional Support in Malnutritional Cancer Patients

Primary Purpose

Pancreatic Cancer, Biliary Cancer, Malnutrition

Status
Completed
Phase
Not Applicable
Locations
Korea, Republic of
Study Type
Interventional
Intervention
nutritional support program
Sponsored by
National Cancer Center, Korea
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring malnutrition, nutrition, nutritional support, hepatobiliary pancreatic cancer, hepatobiliary pancreatic surgery

Eligibility Criteria

20 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects in anticipating major surgery of hepatobiliary pancreatic cancer
  2. Patients diagnosed with malnutrition (at least more than one)

    1. PG-SGA B or C
    2. Weight loss >10% within 6 month
    3. BMI <18.5
    4. Serum Albumin <3.0
  3. Age less than 80 years old over 20 years old
  4. Performance status (ECOG scale): 0-1
  5. Adequate organ functions

    1. Hb ≥7.0 g/dl
    2. ANC ≥1,500/mm3
    3. PLT ≥80,000/mm3
    4. Liver function: AST/ALT ≤5×upper limit of normal
    5. Creatinine ≤2.0 ULN

Exclusion Criteria:

  1. Biopsy, drainage tube insertion, and other minor surgery
  2. palliative surgery
  3. Serious illness or medical conditions, as follows;

    1. congestive heart failure (NYHA class III or IV)
    2. unstable angina or myocardial infarction within the past 6 months,
    3. significant arrhythmias requiring medication and conduction abnormality such as over 2nd degree AV block
    4. uncontrolled hypertension
    5. hepatic cirrhosis( ≥ Child class B)
    6. interstitial pneumonia, pulmonary adenomatosis
    7. psychiatric disorder that may interfere with and/or protocol compliance
    8. unstable diabetes mellitus
    9. uncontrolled ascites or pleural effusion
    10. active infection
  4. Pregnancy
  5. Any patients judged by the investigator to be unfit to participate in the study

Sites / Locations

  • National Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

nutritional support program apply

historical control group

Arm Description

Preoperative nutritional support program is given for 5 or more days preoperatively by nutritional support program.

Historical control group is that did not receiving

Outcomes

Primary Outcome Measures

postoperative complication
expected the duration of hospital stay of postoperation is 4~6 weeks.

Secondary Outcome Measures

postoperative hospital stay
expected the duration of hospital stay of postoperation is 4~6 weeks.
quality of life
preoperative, postoperative 14days
postoperative cost( + nutritional support cost)
expected the duration of hospital stay of postoperation is 4~6 weeks.

Full Information

First Posted
June 8, 2015
Last Updated
June 7, 2018
Sponsor
National Cancer Center, Korea
Collaborators
Fresenius Kabi
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1. Study Identification

Unique Protocol Identification Number
NCT02626195
Brief Title
Preoperative Nutritional Support in Malnutritional Cancer Patients
Official Title
Prospective Study of Preoperative Nutritional Support in Malnutritional Pancreatobiliary Cancer Patients
Study Type
Interventional

2. Study Status

Record Verification Date
June 2018
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
November 27, 2013 (Actual)
Study Completion Date
April 5, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
National Cancer Center, Korea
Collaborators
Fresenius Kabi

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Malnutrition patients are known to have more postoperative complications and mortality. And most of hepatobiliary-pancreatic cancer surgeries accompany high postoperative morbidity and mortality rate. Therefore for the malnourished patients anticipating major surgery, preoperative nutritional support is recommended according to the ASPEN (American society of parenteral and enteral nutrition) and ESPEN (European society of parenteral and enteral nutrition) guideline. However there is no prospective trial to prove the clinical impact of preoperative nutritional support for malnourished patients. The purpose of this study is to evaluate the clinical impact of preoperative nutritional support for malnourished cancer patients anticipating HBP surgery. Primary objective is to compare the complication rate and secondary object is to compare the quality of life, hospital stay and cost.
Detailed Description
This is single arm study with historical comparison. The historical control group did not receiving nutritional support. In previous results show that about 25% complication rates. Complication rates are expected in the group receiving nutritional support is less than 10 % ( previous studies (NCCNCS-11-460)). For support group, preoperative nutritional support is given for 5 or more days preoperatively by nutritional support program. Nutritional support program is briefly described below. Interval: 5-10 days Contents: admission is required Calories: 30-35Kg, via enteral or parenteral Protein: 1.2-1.5g/Kg Lipid : 1-1.5g/Kg Mineral and vitamins supply Blood glucose control Daily monitoring by dietician and specialized nurse

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer, Biliary Cancer, Malnutrition
Keywords
malnutrition, nutrition, nutritional support, hepatobiliary pancreatic cancer, hepatobiliary pancreatic surgery

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
nutritional support program apply
Arm Type
Experimental
Arm Description
Preoperative nutritional support program is given for 5 or more days preoperatively by nutritional support program.
Arm Title
historical control group
Arm Type
No Intervention
Arm Description
Historical control group is that did not receiving
Intervention Type
Dietary Supplement
Intervention Name(s)
nutritional support program
Intervention Description
Nutritional support program is briefly described below. Interval: 5-10 days Contents: admission is required Calories: 30-35Kg, via enteral or parenteral Protein: 1.2-1.5g/Kg Lipid : 1-1.5g/Kg Mineral and vitamins supply Blood glucose control Daily monitoring by dietician and specialized nurse
Primary Outcome Measure Information:
Title
postoperative complication
Description
expected the duration of hospital stay of postoperation is 4~6 weeks.
Time Frame
at discharge. (expected the duration of hospital stay of postoperation is 4~6 weeks.)
Secondary Outcome Measure Information:
Title
postoperative hospital stay
Description
expected the duration of hospital stay of postoperation is 4~6 weeks.
Time Frame
expected the duration of hospital stay of postoperation is 4~6 weeks.
Title
quality of life
Description
preoperative, postoperative 14days
Time Frame
preoperative, postoperative 14days
Title
postoperative cost( + nutritional support cost)
Description
expected the duration of hospital stay of postoperation is 4~6 weeks.
Time Frame
at discharge. (expected the duration of hospital stay of postoperation is 4~6 weeks.)
Other Pre-specified Outcome Measures:
Title
immunologic change(CD4/CD8) after nutritional support
Description
CD4/CD8, immunoglobulin G, M, A
Time Frame
preoperative, postoperative 14days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects in anticipating major surgery of hepatobiliary pancreatic cancer Patients diagnosed with malnutrition (at least more than one) PG-SGA B or C Weight loss >10% within 6 month BMI <18.5 Serum Albumin <3.0 Age less than 80 years old over 20 years old Performance status (ECOG scale): 0-1 Adequate organ functions Hb ≥7.0 g/dl ANC ≥1,500/mm3 PLT ≥80,000/mm3 Liver function: AST/ALT ≤5×upper limit of normal Creatinine ≤2.0 ULN Exclusion Criteria: Biopsy, drainage tube insertion, and other minor surgery palliative surgery Serious illness or medical conditions, as follows; congestive heart failure (NYHA class III or IV) unstable angina or myocardial infarction within the past 6 months, significant arrhythmias requiring medication and conduction abnormality such as over 2nd degree AV block uncontrolled hypertension hepatic cirrhosis( ≥ Child class B) interstitial pneumonia, pulmonary adenomatosis psychiatric disorder that may interfere with and/or protocol compliance unstable diabetes mellitus uncontrolled ascites or pleural effusion active infection Pregnancy Any patients judged by the investigator to be unfit to participate in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
SangJae Park
Organizational Affiliation
National Cancer Center, Korea
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Cancer Center
City
Goyang-si
State/Province
Gyeonggi-do
ZIP/Postal Code
410-769
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
No

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Preoperative Nutritional Support in Malnutritional Cancer Patients

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