Cancer Research, Food Science, Endocrinology, Diabetes and Metabolism, Public Health, Environmental and Occupational Health
3
Scopus Publications
Scopus Publications
Immunonutrition in Radical Cystectomy: State of the Art and Perspectives Amanda Casirati, Valentina Da Prat, Arianna Bettiga, Lucia Aretano, Francesco Trevisani, Emanuele Cereda, Alberto Briganti, Elisa Colombo, Giorgia Preziati, Francesca De Simeis, Andrea Salonia, Francesco Montorsi, Riccardo Caccialanza, Richard Naspro Cancers, 2023 Preoperative nutritional status is a pivotal aspect to consider in patients with cancer undergoing radical cystectomy (RC), as those at risk of malnutrition or already malnourished are more prone to post-surgical complications. The loss of muscle mass is a major consequence of cancer-related malnutrition. It is associated with increased risk of hospital readmission, longer hospitalization, and higher mortality. Nowadays, the close relationship between nutritional and immunological aspects under stressful conditions, such as surgery, represents an emerging scientific and clinical issue. Indeed, the synergistic action of reduced food intake and systemic inflammation generates metabolic derangements with tissue catabolism, including skeletal muscle breakdown, which is, in turn, associated with immune system dysfunction. In order to offer an additional immune-nutritional boost to the post-surgical phase, particularly in malnourished patients, nutritional support may include oral nutritional supplements and/or enteral formulas enriched with specific nutrients such as omega-3 fatty acids, arginine, glutamine, and nucleotides, with acknowledged immune-modulating effects. In the present narrative review, we addressed the state of the art of the available scientific literature on the benefit of immunonutrition in patients undergoing RC for cancer and suggest possible future perspectives to be explored. Although the role of immunonutrition was found to be little explored in the context of urologic oncology, the preliminary available data on radical cystectomy, summarized in the present paper, are promising and suggest that it may improve postoperative outcomes through immunomodulation, regardless of nutritional status before surgery.
THE COMPLEX REALITY OF MALNUTRITION MANAGEMENT IN ONCOLOGY V. Da Prat, E. Colombo, G. Preziati, L. Perrone, F. Serra, R. Caccialanza, P. Pedrazzoli Annals of Research in Oncology, 2023 Clinicians often consider nutritional care as a non-essential step in patients’ evaluation and treatment. This also happens in oncology, even though it is well known that an altered nutritional status has a disastrous impact on patients’ response to treatment, quality of life, and survival. Overall, it has been estimated that up to 57% of patients … Continued
DIETARY COUNSELING IN REHABILITATION FOLLOWING GASTRIC CANCER SURGERY Caccialanza, R. Journal of Cancer Rehabilitation, 2023 Gastric cancer patients undergoing surgical procedures, such as total or subtotal gastrectomy, often encounter a range of challenging symptoms during postoperative rehabilitation. Indeed, surgery alters patients' gastrointestinal anatomy and physiological functions, affecting nutrient absorption and giving rise to gastrointestinal symptoms. Common symptoms include dumping syndrome, diarrhea, gastroesophageal reflux as well as nausea and early satiety. Moreover, the severity of these symptoms can lead to additional psychological distress and negatively impact oral food intake. Disturbances in symptoms and systemic inflammation, related to cancer and surgery along with emotional distress, can progressively contribute to wasting, ultimately resulting in weight loss. Following gastrectomy, most patients experience insufficient protein and calorie intake, leading to continued weight loss over an extended period. Malnutrition stands as a risk factor for postoperative complications and a poor prognosis. Therefore, to prevent this and ensure a swift recovery after surgery, individualized nutritional interventions led by dietary counseling should be consistently carried out. This should be done both during the postoperative hospitalization period (aimed at gradually increasing oral feeding intake) and in the subsequent phase at home (by providing nutritional advice to fully meet nutritional requirements and regain an adequate diet). Understanding the issues that affect patients' nutritional status after gastric cancer surgery is a critical aspect of rehabilitation programs, which are designed to enhance clinical outcomes and optimize quality of life.
