Email this article Energy requirements in patients with upper gastrointestinal cancer prior to radical surgery as assessed by indirect calorimetry
- Authors: Obukhova O.A.1, Kurmukov I.A.1, Yunaev G.S.1
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Affiliations:
- Russian Cancer Research Center NN Blokhin
- Issue: Vol 5, No 4 (2024)
- Pages: 160-167
- Section: Original Study Articles
- URL: https://journals.rcsi.science/2658-4433/article/view/315173
- DOI: https://doi.org/10.17816/clinutr686847
- EDN: https://elibrary.ru/UCIMBU
- ID: 315173
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Abstract
BACKGROUND: Nutritional support (NS) is an essential component of prehabilitation before surgical intervention in cancer patients with upper gastrointestinal (GI) tract cancer who have completed neoadjuvant chemotherapy (NACT). However, their actual energy requirements remain poorly understood.
AIM: The work aimed to determine energy requirements using indirect calorimetry (IC) in patients with malignant tumors of the upper GI tract who had completed NACT and were scheduled for radical surgical intervention.
METHODS: This observational, cross-sectional, single-center study included patients with upper GI tract cancer who completed NACT and were scheduled for radical surgery. Upon admission, body weight and height were measured. Body mass index (BMI) and weight loss over the preceding six months (as % of usual body weight) were calculated. Energy requirements were assessed via IC and also calculated using the Harris–Benedict equation with stress factors. The degree of protein-energy malnutrition (PEM) was classified according to GLIM criteria. Daily energy intake was calculated. Statistical analysis was performed using Microsoft Excel 2011. Data are presented as Me [Q1; Q3].
RESULTS: A total of 42 patients (24 males) were assessed; median age was 64 years [57; 72]. Esophageal cancer was diagnosed in 26 patients (61.9%), gastric cancer in 16 (38.1%). Median 6-month weight loss was 11.53% [8.62; 20.04], BMI was 24 [19.5; 26.88] kg/m2. IC-based basal metabolic rate (BMR) was 1485.5 [1327.75; 1622.25] kcal/day; actual energy requirement (AER) was 1960.86 [1752.63; 2141.37] kcal/day, or 28.37 [26.23; 32.78] kcal/kg. According to the Harris–Benedict equation, BMR was 1391.43 [1264.22; 1525.49] kcal/day, AER was 1836.69 [1668.78; 2013.64] kcal/day, or 27.35 [25.73; 30.24] kcal/kg. Caloric intake was 1232.00 [967.00; 1479.25] kcal/day, or 18.91 [15.90; 21.18] kcal/kg. The IC method yielded greater variability compared to calculated estimates. Moderate PEM was diagnosed in 15 patients (35.7%), and severe PEM in 27 (64.3%).
CONCLUSION: Patients with upper GI tract cancer who have undergone NACT present with PEM, the primary diagnostic criterion being unintentional weight loss over the preceding six months. IC-based BMR measurements provide more individualized results than those derived from the Harris–Benedict equation.
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##article.viewOnOriginalSite##About the authors
Olga A. Obukhova
Russian Cancer Research Center NN Blokhin
Author for correspondence.
Email: obukhova0404@yandex.ru
ORCID iD: 0000-0003-0197-7721
SPIN-code: 6876-7701
MD, PhD, Cand. Sci. (Medicine)
Russian Federation, MoscowIldar A. Kurmukov
Russian Cancer Research Center NN Blokhin
Email: kurmukovia@gmail.com
ORCID iD: 0000-0001-8463-2600
SPIN-code: 3692-5202
MD, PhD, Cand. Sci. (Medicine)
Russian Federation, MoscowGrigory S. Yunaev
Russian Cancer Research Center NN Blokhin
Email: garik_dr@mail.ru
ORCID iD: 0000-0002-9562-9113
SPIN-code: 4410-8937
Russian Federation, Moscow
References
- Obukhova OA, Kurmukov IA, Ryk AA. The effect of nutritional support on nutritional status, quality of life, and survival in cancer patients receiving systemic anticancer therapy. Clinical nutrition and metabolism. 2022;3(1):50-61. doi: 10.17816/clinutr104771 EDN: VJKFTI
- Obukhova OA, Bagrova SG, Besova NS, et al. Evaluation of nutritional status of patients with inoperable gastric cancer at the start of antitumor treatment. Preliminary results of a prospective observational study. Difficult patient. 2018;16(6):6-11. (In Russ.) EDN: UYUQCM
- Cederholm T, Jensen GL, Correia MITD, et al. GLIM criteria for the diagnosis of malnutrition – a consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9. doi: 10.1016/j.clnu.2018.08.002
- Petrikov SS, Khubutia MSh, Popova TS, editors. Parenteral and enteral nutrition: national guidelines. 2nd ed. Moscow: GEOTAR-Media, 2023. (In Russ.) doi: 10.33029/9704-7277-4-PAR-2023-1-1168 EDN: FXMQGG
- Oshima T, Berger MM, Waele ED, et al. Indirect calorimetry in nutritional therapy. A position paper by the ICALIC study group. Clin Nutr. 2017;36(3):651-662. doi: 10.1016/j.clnu.2016.06.010
- Baranovsky AYu, editor. Dietetics. 5th ed. Saint Petersburg: Peter, 2017. (In Russ.)
- Dreval AV, Vysotsky VG, Yatsyshina TA, et al. Indirect calorimetry in the differential diagnosis of the metabolic status of obese patients with non-insulin dependent diabetes mellitus. Problems of Endocrinology. 1993; 39(2):4-7. (In Russ.) doi: 10.14341/probl11937 EDN: KJWSET
- Mazzo R, Ribeiro FB, Vasques ACJ. Accuracy of predictive equations versus indirect calorimetry for the evaluation of energy expenditure in cancer patients with solid tumors — An integrative systematic review study. Clin Nutr ESPEN. 2020;35:12-19. doi: 10.1016/j.clnesp.2019.11.001 EDN: UVORNI
- Barcellos PS, Borges N, Torres DPM. Resting energy expenditure in cancer patients: agreement between predictive equations and indirect calorimetry. Clin Nutr ESPEN. 2021;42:286-291. doi: 10.1016/j.clnesp.2021.01.019 EDN: BWVMWD
- Ławiński M, Ksepka N, Mickael ME, et al. Predictive equations in determining resting energy expenditure in patients with head and neck cancer receiving home enteral nutrition. Nutrition. 2025;131:112636. doi: 10.1016/j.nut.2024.112636 EDN: WRZZHH
- Ivanova AS, Obukhova OA, Kurmukov IA, Volf LYa. Review of ESPEN-2021 Practice Guidelines for Cancer Patients: Part 1. Clinical nutrition and metabolism. 2022;3(3):140-152. doi: 10.17816/clinutr111900 EDN: YLUOMT
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