Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Reply
  • Published:

Perioperative nutritional intervention: a way to improve long-term outcomes

Nature Reviews Clinical Oncology volume 13, page 198 (2016)Cite this article

Subjects

Access through your institution
Buy or subscribe

We would like to thank Molfino and Laviano for their Correspondence article on our Review article (Cachexia in patients with oesophageal cancer. Nat. Rev. Clin. Oncol. http://dx.doi.org/10.1038/nrclinonc.2015.200 (2015))1, in which they acknowledge our work and provide their extended views on the subjects we covered (Perioperative nutritional intervention: a way to improve long-term outcomes. Nat. Rev. Clin. Oncol. http://dx.doi.org/10.1038/nrclinonc.2016.20 (2016))2. We agree with the authors that, in addition to interventions that aim to counteract muscle loss and improve muscle function, perioperative nutritional interventions to improve immune function are of great importance and are an under-researched aspect of oesophageal cancer care. Indeed, we emphasized in our Review1 (in the 'Treatment: Artificial nutritional support: During the peri-operative period' section) the importance of perioperative immunonutritional support, and stated that the European Society for Clinical Nutrition and Metabolism (ESPEN) has given a grade A recommendation (highly recommended) for the use of enteral nutritional support with immune-modulating substrates, such as arginine, omega-3 fatty acids, and nucleotides, in patients undergoing major abdominal surgery, independent of nutritional status3. In the same section of our Review1, we also discussed the existing evidence that indicates the role of immunonutrition in determining long-term patient outcomes, including survival. We second the views of Molfino and Laviano2, who have highlighted findings from more-recent studies than those discussed in our Review, as well as the possible mechanisms behind the effects of immunonutrition — and, therefore, the need for more and larger-sized clinical trials evaluating its effect in a patient group such as oesophageal cancer survivors, in whom immune function is compromised considerably throughout the cancer trajectory, especially during neoadjuvant therapy. Thus, the authors' Correspondence adds valuable insights into the potential of immunonutrition, during the perioperative period, to improve the long-term outcomes of such patients.

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Anandavadivelan, P. & Lagergren, P. Cachexia in patients with oesophageal cancer. Nat. Rev. Clin. Oncol. http://dx.doi.org/10.1038/nrclinonc.2015.200 (2015).

  2. Molfino, A. & Laviano, A. Perioperative nutritional intervention: a way to improve long-term outcomes. Nat. Rev. Clin. Oncol. http://dx.doi.org/10.1038/nrclinonc.2016.20 (2016).

  3. Arends, J. et al. ESPEN Guidelines on enteral nutrition: non-surgical oncology. Clin. Nutr. 25, 245–259 (2006).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Poorna Anandavadivelan and Pernilla Lagergren are at the Departments of Molecular Medicine and Surgery, Karolinska Institutet, Norra Stationsgatan 67, Level 2, Stockholm 17176, Sweden.,

    Poorna Anandavadivelan & Pernilla Lagergren

Authors
  1. Poorna Anandavadivelan
    View author publications

    Search author on:PubMed Google Scholar

  2. Pernilla Lagergren
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Pernilla Lagergren.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Anandavadivelan, P., Lagergren, P. Perioperative nutritional intervention: a way to improve long-term outcomes. Nat Rev Clin Oncol 13, 198 (2016). https://doi.org/10.1038/nrclinonc.2016.21

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/nrclinonc.2016.21

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing