Impact of oral immunonutrition on functional outcomes in patients who underwent radical prostatectomy for prostate cancer

Abstract

Aim: The effect of oral nutritional support on prostate cancer (PCa), especially the functional outcomes, has been severely questioned. We present the results of a controlled trial to determine the effects of oral nutritional support on functional outcomes after radical prostatectomy. Methods: This is a prospectively designed, randomized controlled trial to evaluate oncological outcomes in the initial period and functional outcomes in the third and sixth months, but the data were obtained retrospectively. Thirty-six patients who underwent laparoscopic radical prostatectomy performed by a single surgeon between October 2017 and August 2018 were included in the study. Eighteen were started on oral immunonutrition (Oral-Impact, Nestle, 3 × 237 ml per day for seven days at home) in the postoperative period for 6 months and 18 control patients received elemental nutrition support without immune-nutrition components. Results: There were no significant differences in demographic and baseline characteristics between the groups. There was no wound infection, urinary tract infection, urinary extravasation, hem-o-lock clip migration to bladder, urinoma, or infected lymphocele after surgery in either group. Continence rates at the third and sixth months and potency rates (P=0.630, P=0.37, respectively) six months after radical prostatectomy were similar. Despite the similarity in both continence rates, they were numerically in favor of the study group. Conclusion: Immunonutrition is associated with early recovery of stress urinary incontinence (SUI) following radical prostatectomy but there was no association between immunonutrition, postoperative morbidity or infectious complications. However, further clinical trials are needed to confirm these promising results.

Keywords

• Nutrition
• prostate cancer
• Urinary incontinence

Oral immünonütrisyonun prostat kanseri için radikal prostatektomili hastalarda fonksiyonel sonuçlar üzerindeki etkisi

Öz

Amaç: Oral beslenme desteğinin prostat kanseri (PK) üzerindeki etkisi, özellikle fonksiyonel sonuçları ciddi şekilde sorgulanmıştır. Oral beslenme desteğinin radikal prostatektomi sonrası fonksiyonel sonuçlar üzerindeki etkisini belirlemek için kontrollü bir çalışmanın sonuçlarını sunuyoruz. Yöntemler: Bu çalışma erken dönem onkolojik sonuçlarını değerlendirmek ve ayrıca üçüncü ve altıncı aylardaki fonksiyonel sonuçları değerlendirmek için prospektif olarak tasarlanmış olup, veriler geriye dönük olarak elde edilmiş, randomize kontrollü bir çalışmadır. Çalışma için Ekim 2017 ile Ağustos 2018 tarihleri arasında tek bir cerrah tarafından laparoskopik radikal prostatektomi yapılan 36 hasta değerlendirildi. Onsekiz hastaya postoperatif dönemde 6 ay boyunca oral immünonütrisyon (Oral-Impact, Nestle, 7 gün evde 3 × 237 ml) başladı ve 18 kontrol hastasına immün beslenme bileşenleri olmayan elemental beslenme desteği verildi. Bulgular: Gruplar arasında demografik ve başlangıç özellikleri açısından önemli bir farklılık yoktu. Her iki grupta da ameliyat sonrası yara enfeksiyonu, idrar yolu enfeksiyonu, üriner ekstravazasyon, hem-o-kilit klipsinin mesaneye göçü, ürinom veya enfekte lenfosel görülmedi. Radikal prostatektomiden altı ay sonra kontinans oranları ve potens oranları (sırasıyla P=0,630, P=0,37) benzerdi. Radikal prostatektomiden üç ay sonra kontinans oranları benzer olmasına rağmen, her ikisi de sayısal olarak çalışma grubu lehine idi. Sonuç: İmmünonütrisyon, radikal prostatektomi sonrası stres üriner inkontinansın (SUI) erken iyileşmesi ile ilişkilidir, ancak immünonütrisyon ve postoperatif morbidite arasında ne enfeksiyöz komplikasyonlar üzerinde bir ilişki yoktur. Bununla birlikte, bu umut verici sonuçları doğrulamak için daha fazla klinik araştırmaya ihtiyaç vardır.

Anahtar Kelimeler

• Beslenme
• Prostat kanseri
• İdrar kaçırma

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