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Nutrition support in pancreatic cancer: An expert statement on practical implementation of French guidelines - 11/08/23

Doi : 10.1016/j.clinre.2023.102153 
Julien Taieb a, , Raëf Abdallah b, Ronan Thibault c, Patrick Pessaux d, Pascal Artru e, Timothée Marchal f, Cindy Neuzillet g
a Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Université Paris-Cité, SIRIC CARPEM comprehensive cancer center, Paris, France 
b Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, University of Paris, Paris, France 
c Nutrition unit, CHU Rennes, INRAE, INSERM, Univ Rennes, NuMeCan, Nutrition Metabolisms Cancer, Rennes, France 
d Head of Department of Digestive Surgery, Nouvel Hôpital Civil, University Hospital Strasbourg, Faculty of Medicine Strasbourg, France 
e Department of Gastroenterology and Digestive Oncology Jean Mermoz Hospital, Lyon, France 
f Department of Supportive and Palliative Care, Institut Curie, Paris, France 
g Head of GI Oncology, Department of Medical Oncology, Curie Institute, Saint Cloud, Versailles Saint-Quentin University (UVSQ) – Paris Saclay University, France 

Corresponding author at: Université Paris-Cité, Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, 20 rue Leblanc, 75015 Paris, France.Université Paris-CitéDepartment of Gastroenterology and Digestive OncologyGeorges Pompidou European Hospital20 rue LeblancParis75015France

Abstract

The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines, shortened in 2021, are widely used for providing the most suitable nutrition support to patients with cancer. However, there is a lack of specialized guidelines for different cancer types. In 2020, members of the French medical and surgical societies involved in digestive oncology, nutrition and supportive care developed the Thésaurus National de Cancérologie Digestive (TNCD) practice guidelines which are specific nutritional and physical activity guidelines for patients with digestive cancers. These guidelines were recently updated in 2022. This review discusses the French intergroup guidelines, specifically in the context of pancreatic cancer at different stages of the disease. Pancreatic cancer is highly prevalent in Europe, with an increasing worldwide incidence over the last three decades. In France alone, about 14,000 new cases of pancreatic cancer are reported annually. More than 60% of patients with pancreatic cancer reportedly experience malnutrition and other nutritional issues which are known to have a negative impact on quality of life, treatment tolerability, general morbidity, and mortality. Given that the recommendations of TNCD guidelines correlate to other guidelines like the International Study Group on Pancreatic Surgery (ISGPS; for the perioperative setting), ESPEN and Spanish Society of Medical Oncology (SEOM) guidelines, their use can be suitably applied in other European countries. This review discusses the recommendations issued by nutrition guidelines, the challenges with effective integration of nutrition support in oncologic treatment, and the proposed algorithms on patient care pathways for pancreatic cancer management in the clinical setting.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Pancreatic cancer, Enteral nutrition, Parenteral nutrition, Physical activity, Perioperative


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Vol 47 - N° 7

Articolo 102153- Agosto 2023 Ritorno al numero
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