Nutritional Supplementation to Improve Colorectal Cancer Surgery (NUTRICOLOR)
Perioperative Nutritional Supplementation to Prevent Postoperative Complications and Improve Postoperative Outcomes After Colorectal Cancer Surgery: a Single-center Unblinded Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Annalisa Maroli, PhD
- Phone Number: 00390282247776
- Email: annalisa.maroli@humanitas.it
Study Contact Backup
- Name: Stefano De Zanet, MS
- Phone Number: 00390282244623
- Email: stefano.dezanet@humanitas.it
Study Locations
-
-
Milano
-
Rozzano, Milano, Italy, 20089
- IRCCS Humanitas Research Hospital
-
Principal Investigator:
- Antonino Spinelli, MD, PhD
-
Contact:
- Annalisa Maroli, PhD
- Phone Number: 00390282247776
- Email: annalisa.maroli@humanitas.it
-
Contact:
- Stefano De Zanet, MS
- Phone Number: 00390282244623
- Email: stefano.dezanet@humanitas.it
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion criteria
- Participants aged more than 18 years old.
- Histological diagnosis of colorectal adenocarcinoma.
- Participants scheduled for elective minimally invasive colorectal resection.
- Participants with a preoperative MUST score equal to or below 2. Exclusion criteria
- Any condition that, in the opinion of the investigator, may interfere with the study procedures.
- Emergent surgery.
- Planned open surgery. Participants undergoing unplanned surgical conversion (from minimally invasive to open) will be withdrawn from the study.
- Any concomitant surgery unrelated to the primitive colorectal cancer (for example, concomitant liver metastasis resection).
- Participants with preoperative MUST score > 2.
- Pregnant or breastfeeding participants. Women of childbearing potential must agree to use a reliable contraceptive method. Otherwise, a pregnancy urine test must be performed at each study visit to exclude a potential pregnancy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Diet optimization (DO)
Dietary optimization will include a tailored diet to maintain or restore a good nutritional status, body composition (e.g.
weight or lean mass gain if necessary), and macro/micronutrient intake in case of deficiencies detected during the nutritional screening.
Participants will be instructed to follow the dietary indications throughout the study, with appropriate adjustments according to following nutritional assessments.
|
Dietary optimization will include a tailored diet to maintain or restore a good nutritional status, body composition (e.g.
weight or lean mass gain if necessary), and macro/micronutrient intake in case of deficiencies detected during the nutritional screening.
Participants will be instructed to follow the dietary indications throughout the study, with appropriate adjustments according to following nutritional assessments.
|
|
Experimental: Diet Optimization and Oral Nutritional Supplementation (DO+ONS)
Participants in the DO+ONS arm will receive dietary optimization and standardized oral nutritional supplementation designed according to the ESPEN guidelines.
The treatment will start 14 days before surgery and will be restored the day after surgery for the following 60 days.
|
Dietary optimization will include a tailored diet to maintain or restore a good nutritional status, body composition (e.g.
weight or lean mass gain if necessary), and macro/micronutrient intake in case of deficiencies detected during the nutritional screening.
Participants will be instructed to follow the dietary indications throughout the study, with appropriate adjustments according to following nutritional assessments.
ONS will consist of LH Blu® (Lionhealth Italia Srl).
LH Blu® is categorized as a food for special medical purposes and is indicated for the treatment of malnourished patients.
ONS will start 14 days before the planned intervention with a tailored dosage decided according to the malnutrition risk (low vs medium).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative complications
Time Frame: 30 days from surgery
|
The rate of postoperative complications occurring within 30 days from surgery
|
30 days from surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative septic complications
Time Frame: 30 days from surgery
|
The rate of postoperative septic complications occurring within 30 days from surgery.
Septic complications are defined according to the criteria proposed by the International Sepsis Definitions Conference and include documented postoperative extra-intestinal infections- such as urinary tract infections and pneumonia-, intra-abdominal septic complications- such as anastomotic leaks, pelvic abscesses, and peritonitis-, surgical site infections, and systemic symptoms of abnormal inflammatory response- such as fever higher than 38°C or C-Reactive Protein (CRP) increase higher than 200 mg/dL for more than two consecutive days
|
30 days from surgery
|
|
Comprehensive Complication Index (CCI)
Time Frame: 30 days from surgery
|
The median Comprehensive Complication Index (CCI) computed from all postoperative complications that occurred within 30 days from surgery.
The CCI ranges from 0 to 100, where 0 indicates the best outcome (no postoperative complications), and 100 indicates the worst outcome (postoperative complications leading to death).
|
30 days from surgery
|
|
Length of hospital stay
Time Frame: 30 days from surgery
|
The median length of hospital stay calculated in days from the day after surgery until the day of discharge
|
30 days from surgery
|
|
Hospital readmission
Time Frame: 30 days from surgery
|
The rate of hospital readmissions- including ward readmission and emergency room accesses- within 30 days from surgery
|
30 days from surgery
|
|
Sarcopenia
Time Frame: Six months after surgery
|
The proportion of participants with sarcopenia six months after surgery.
Sarcopenia will be assessed from the Skeletal Muscle Index (SMI) computed from the abdominal Computed Tomography (CT) scans collected at screening and 6 months after surgery.
SMI less than 7.0 kg/m2 for men and less than 5.5 kg/m2 for women will be considered indicative of sarcopenia.
|
Six months after surgery
|
|
Normal weight
Time Frame: 60 days after surgery
|
The proportion of participants with normo-weight Body Mass Index (BMI) measures at 60 days after surgery.
Normal BMI values ranges from 18.5 Kg/m2 and 24.9 Kg/m2.
|
60 days after surgery
|
|
Mini Nutritional Assessment (MNA) score
Time Frame: 60 days after surgery
|
The median Mini Nutritional Assessment (MNA) score collected 60 days after surgery.
The MNA score ranges from 0 (worst possibile nutritional status) to 30 (best possible nutritional status).
|
60 days after surgery
|
|
EuroQoL-5 Dimension- 5 Levels (EQ5D5L) score
Time Frame: 60 days after surgery
|
The median EuroQoL-5 Dimension- 5 Levels (EQ5D5L) score collected 60 days after surgery.
The EQ5D5L score ranges from 0 (worst possible perceived health) to 25 (best possible perceived health).
|
60 days after surgery
|
|
Proctitis
Time Frame: Six months after surgery
|
The proportion of participants with clinical signs of active proctitis six months after surgery.
Active proctitis will be assessed through rigid or flexible sigmoidoscopy and will be defined by the presence of any of the following findings: friable mucosa with edema, oozing, or ulcerations; bleeding; wall thickening; pseudopolyps; strictures; stenosis; loss of normal curvature; necrosis; perforations; fistula.
The severity of proctitis will be classified using the RTOG/EORTC grading system
|
Six months after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Antonino Spinell, MD, PhD, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Intestinal Diseases
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Digestive System Diseases
- Gastrointestinal Diseases
- Intestinal Neoplasms
- Rectal Diseases
- Colonic Diseases
- Colorectal Neoplasms
- Food
- Diet, Food, and Nutrition
- Physiological Phenomena
- Food and Beverages
- Dietary Supplements
Other Study ID Numbers
Other Study ID Numbers
- CHR1-11-2025
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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