medigraphic.com
ISSN 1561-2945 (Print)

2016, Number 2

Next >>

Revista Cubana de Cirugía 2016; 55 (2)

Nutritional support and quality of life in patients with esophageal cancer and cardias

Oliva ACA, Mederos CON, García SJC, Barrera OJC, Castellanos GJA

Language: Spanish
References: 39
Page: 97-105
PDF size: 107.61 Kb.


ABSTRACT

Introduction: esophageal cancer is a malignancy of the digestive tract with the worst prognosis. Its treatment constitutes a challenge in the case of patients with nutritional deterioration and inability to ingest food. Most of them are candidates for palliative treatment.
Objective: to describe the experience regarding the nutritional care of patients with esophageal cancer and cardias, with the introduction of the nutritional support group at "Comandante Manuel Fajardo" University Hospital.
Method: 126 patients with esophageal cancer and cardia presented: 51 of them with resectable lesions and who underwent esophagectomy, and 75 with advanced cancer and palliative interventions, treated from 2006 to 2015, according to the performance protocols of the nutritional support group.
Results: all patients were at age 46-76 years (69 % over 60 years), 87.3 % were male, 90 % had a history of smoking and 80 % of alcohol. The predominant location of the tumor was the third-lower esophagus and the cardia, followed by the middle and upper thirds. They had mild malnutrition (4,1%), 53,9% had moderate and 42 %, severe malnutrition. All of them showed decreased albumin and 57,9% showed decreased functional capacity. All of them received dietary counseling and oriented diet therapy. Survival after 14 months was increased in the palliative cases and after 39 months in respective cases, compared with a previous period without the presence of the nutritional support group.
Conclusions: nutritional assessment should be part of the clinical evaluation of patients with esophageal cancer from the time of diagnosis and during illness, in order to identify and correct nutritional deficit, maintain and preserve the weight, thus improving response to cancer treatments, and increasing survival, which improves quality of life.


REFERENCES

  1. Mederos Curbelo ON, Leal Mursulí A, García Gutiérrez A, Barrera Ortega JC, Valdés Jiménez J, Romero Díaz CA. Qué hacen y qué hacemos en el cáncer de esófago y cardias. Rev Cubana Cir. 2005;44(4). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74932005000400010&lng=es&nrm=iso&tlng=es

  2. Enzinger PC, Mayer RJ. Esophageal Cáncer. NEJM. 2003;349:2241-52.

  3. Mc Quaid KR. Lesiones Esofágicas Malignas. En: Mcphee SJ, Papadakis MA, Tierney LM. Diagnóstico Clínico y Tratamiento. 39 ed. México: El Manual Moderno; 2005:547-9.

  4. Ayre AM, Fernández A, Coco JE. Tratamiento del cáncer de esófago: Revisión. Revista de Posgrado de la Cátedra de Medicina [en línea]. 2003[Citado 15 de mayo de 2012];126:37-41. Disponible en: http://www.med.unne.edu.ar/revista/revista126/tratamiento.htm

  5. Barreras Ortega JC, Mederos Curbelo ON, Romero Díaz CA, Cantero Ronquillo A, Del Campo Abad RJ, Valdés Jiménez J. Cáncer no resecable de esófago y cardias. ¿Prótesis o tubo gástrico? Arch Cir Gen Dig. 2005[Citado 15 de mayo de 2012];44(4). Disponible en: http://www.cirugest.com/revista/2005/02/2005-01- 24.htm

  6. Cáncer de esófago. En: Enfermedades y tratamientos. Disponible en: http://www.cun.es/areadesalud/enfermedades/cancer/cancer-de-esofago/

  7. Eslick GD. Epidemiology of esophageal cancer. Gastroenterol Clin North Am. 2009;38:17-25.

  8. Tomizawa Y, Wang K. Screening, Surveillance, and Prevention for Esophageal Cancer. Gastroenterol Clin North Am. 2009;38:59-73.

  9. Loaeza-del Castillo A, Villalobos-Pérez J. Estudio de 30 años sobre el cambio en la frecuencia de carcinoma epidermoide esofágico, adenocarcinoma esofágico y adenocarcinoma de la unión esofagogástrica. Rev Gastroenterol Mex. 2008;73(1):11-6.

  10. Goyal RK. Disease of the Esophagus. En: Kasper DL, Braun Wald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, ed. Harrison's Principles of Internal Medicine. 16 th Edition. New York: McGraw-Hill; 2005. p. 1739-1743.

  11. Klag MJ. Digestive Disease Library Esophagus Cancer. TJH MIGH [en línea] 2007 [Citado 22 de diciembre de 2006]. Disponible en: http://hopkinsgi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&organ =1&disease=14&l

  12. Lacy BE, Weiser K, Chertoff J. The diagnosis of gastroesophageal disease. Am J Med. 2010;123:583-92.

  13. Rastogi A, Puli S, El Serag HB. Incidence of esophageal adenocarcinoma in patients with Barrett`s esophagus and high grade dysplasia: a meta-analysis. Gastrointest Endosc. 2008;67:394-98.

  14. Sharma P, Falk GA, Weston AP. Dysplasia and cancer in a large multicenter cohort of patients with Barrett`s esophagus. Clin Gastroenterol Hepatol. 2006;4:566-72.

  15. Updated guidelines 2008 for the diagnosis, surveillance, and therapy of Barrett`s esophagus. Am J Gastroenterol. 2008;103:788-97.

  16. Seewald S, Ang TL, Soehendra N. Endoscopic mucosal resection of Barrett's esophagus containing dysplasia or intramucosal cancer. Postgrad Med. 2007;83:367-72.

  17. Murphy PM, Modi P, Rahamim J. An investigation into the current peri-operative nutritional management of oesophageal carcinoma patients in major carcinoma centres in England. Ann R Coll Surg Engl. 2006;88:358.

  18. Hoda D, Jatoi A, Burnes J. Should patients with advanced, incurable cancers ever be sent home with total parenteral nutrition. Cancer. 2005;103:863.

  19. Lecleire S, Di Fiore F, Antonietti M, Ben Soussan E, Hellot MF, Grigioni S. Undernutrition is predictive of early mortality after palliative self-expanding metal stent insertion in patients with inoperable or recurrent esophageal cancer. Gastrointest Endose. 2006;64:479-84.

  20. Pultrum BB, van Westreenen HL, Mulder NH, van DuUemen HM, Plukker JT. Outcome of palliative care regimens in patients with advanced oesophageal cancer detected during explorative surgery. Antieaneer Res. 2006;26:2289-93.

  21. Rocabruna Pedroso R. Nutrición en cirugía. Rev Cubana Cir. 2009;48(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74932009000100016&lng=es&nrm=iso&tlng=es

  22. Instituto Nacional del Cáncer. Cáncer del esófago: Tratamiento. INC [en línea] 2007 [Citada 15 de mayo de 2012]. Disponible en: http://www.cancer.gov/espanol/pdq/tratamiento/esofago/

  23. Politi PM. Cáncer de esófago: alternativas a la cirugía en el año 2007. Resultados a largo plazo. [En línea] 2007 [Citado 3 de mayo de 2007]. Disponible en: http://www.cancerteam.com.ar/poli181.htm

  24. Cavada D. Tratamiento quirúrgico del cáncer de Esófago. AAC [en línea] 2006 [Citado 23 de abril de 2007]. Disponible en: http://www.aac.org.ar/Pdf/ut0702.pdf

  25. Mata A, Llach J, Bordas JM. Tratamiento paliativo del cáncer de esófago. GHC [en línea] 2007 [Citado 15 de mayo de 2012 en];6:68-71. Disponible en: http://www.ghcontinuada.com/contenidos/pdf/v6n2a398 pdf001.pdf

  26. Oñate OLF, Milán RG, Aiello CV, Carrillo JF, Gallardo RD, Brom-Valladares R. Treatment of the adenocarcinoma of the esophagogastric junction at a single institution in Mexico. Ann Surg Oncol. 2007;14:1439-48.

  27. Lagarde SM, Ten Kate FJW, Reitsma JB, Busch ORC, Van Lanschot JB. Prognostic factors in adenocarcinoma of the esophagus or gastroesophageal junction. J Clin Oncol. 2006;24(26):4347-55.

  28. Besharat S, Jabbari A, Semnani S, Keshtkar A, Marjani J. Inoperable esophageal cancer and outcome of palliative care. World J Gastroenterol. 2008;14(23):3725-8.

  29. Keller R, Flieger D, Fischbach W, Christi SU. Self-expanding metal stents for malignant esophagogastric obstruction: experience with a new design covered nitinol stent. Gastrointestin liver Dis. 2007;16:239-43.

  30. Barrera Ortega JC, Mederos Curbelo ON, Da Costa Fernández JM, Gigato Díaz A. Efectividad del alcohol absoluto para canalizar los tumores irrresecables de esófago. Rev Cub Cir. 2010;49(4):9-14.

  31. Barreras Ortega JC, Mederos Curbelo ON, Romero Díaz C, Cantero Ronquillo A, Menchaca Díaz JL, Castellano JA. Estrategia en el cáncer de esófago torácico y cardias irresecable. Rev Cub Cir. 2001;40(2):119-22.

  32. Conigliaro R, Battaglia G, Repici A, De Pretis G, Ghezzo L, Bittinger M. Polyflex stents for malignant oesophageal and oesophagogastric stricture: a prospective, multicentric study. Eur Gastroenterol Hepatol. 2007;19:195-203.

  33. Javle M, Ailawadhi S, Yang GY, Nwogu CE, Schiff MD, Nava HR. Palliation of malignant dysphagia in esophageal cancer: a literature-based review. Oncol. 2006;4:365-73.

  34. Mederos Curbelo ON, Barreras Ortega JC, Romero Diaz CA, Cantero Ronquillo A, Menchaca Diaz JL. Bypass gástrico tubular isoperistáltico (Postlethwait) en el cáncer de esófago irresecable. Rev Cubana Oncol. 2001;17(2):135-7.

  35. Law S, Wong J. The Current Management of Esophageal Cancer. Adv Surg. 2007;41:93-119.

  36. Romero Díaz C, Mederos Curbelo ON, Barrera Ortega JC, Valdés Jiménez JM, Cantero Ronquillo A. Cirugía oncológica. Mejor calidad de vida en cáncer de esófago. Revista Avances Médicos de Cuba. 2000;24(4):50-2.

  37. Täte H. The Palliation of Dysphagia in Oesophageal Malignant Obstructions Using Endoprostheses: A Review of the Literature. Newcastle upon Tyne: Priory Lodge Education Ltd; 2007.

  38. Fernández Aguilar M, Manrique Rionda E, Marchena Pérez E. Sobrevida de dos pacientes con cáncer de esófago inoperable tratados con recanalización endoscópica. Medicentro Electrónica. 2008;12(2):62-4.

  39. Cruz-Zárate A, Hernández-Guerrero A, Sobrino-Cossio S, Barranco-Fragoso B, Alonso-Lárraga JO. Supervivencia y factores pronósticos en cáncer esofágico. Revista Médica del Hospital General de México. 2010;73(1):23-9.




2020     |     www.medigraphic.com