Skip to main content

Master of Public Health

Perioperative Oral Nutrition Supplementation Reduces Prevalence of Sarcopenia following Radical Cystectomy: Results of a Prospective Randomized Controlled Trial

AUTHORS

Ritch CR , Cookson MS , Clark PE , Chang SS , Fakhoury K , Ralls V , Thu MH , Penson DF , Smith JA , Silver HJ , . The Journal of urology. 2018 10 22; ().

ABSTRACT

PURPOSE: We designed a prospective randomized controlled pilot trial to investigate the effects of an enriched oral nutrition supplement (ONS) on body composition and clinical outcomes following radical cystectomy (RC).

MATERIALS AND METHODS: 61 patients were randomized to ONS or multivitamin multimineral supplement (MVI) twice daily during an 8-week perioperative period. Body composition was determined by analysis of abdominal CT images at the L3 vertebra. Sarcopenia was defined as skeletal muscle index <55 cm/m in males and <39 cm/m in females. The primary outcome was difference in 30-day hospital free days (HFDs). Secondary outcomes included hospital length of stay (LOS), complications, readmissions, and mortality.

RESULTS: The ONS group lost less weight (-5kg vs -6.5kg, p=0.04) compared to the MVI group. The proportion of patients with sarcopenia did not change in ONS group, but increased 20% in MVI group (p=0.01). Mean LOS and 30-day HFDs were similar between groups. ONS group had a lower rate of overall and major (Clavien grade ≥3) complications (48% vs 67%; 19% vs 25% respectively) and lower readmission rates (17% vs 7%), but the differences did not reach statistical significance.

CONCLUSIONS: RC patients consuming ONS perioperatively have a reduced prevalence of sarcopenia and may also experience fewer and less severe complications and readmissions. A larger blinded randomized controlled trial is necessary to determine whether ONS interventions can improve outcomes following RC.

Tags: