- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07584577
Evaluation of the Administration of Artificial Nutrition by Feeding Jejunostomy During Neoadjuvant Treatment on Postoperative Morbidity in the Context of Esophageal or Stomach Cancer (FREJENO)
Study Overview
Status
Intervention / Treatment
Detailed Description
Malnutrition is frequently associated with esogastric cancers at diagnosis (65-80% of cases). It has been shown that malnutrition in digestive oncology is linked to increased mortality, higher rates of postoperative complications, greater toxicity induced by chemoradiotherapy, and reduced survival. Furthermore, malnutrition present before the start of neoadjuvant treatment is likely to worsen during therapy, due to the occurrence of diarrhea, malabsorption, and dysgeusia during chemotherapy.
However, there are no recommendations regarding the use of nutritional support (type and duration) during the neoadjuvant treatment phase for esogastric cancers. Indeed, the data in the literature are quite heterogeneous regarding the duration of preoperative nutrition, ranging from a few days to several weeks, as well as the type of nutritional support to be used. No study has specifically investigated the evolution of nutritional status during this refeeding phase. As for postoperative complications, the results are mixed, although the trend suggests a reduction in postoperative complications for esophageal surgery. For gastric surgery, only one study examined surgical site infections and found a decrease in incidence when adequate nutrition was provided for more than 14 days before surgery. Nevertheless, postoperative mortality was not affected by improved nutritional status. Most of these studies are small retrospective series. The only prospective studies assessed preoperative nutrition for just 7 days before surgery, with limited sample sizes.
An educational review was published in 2012 highlighting the importance of nutritional support in malnourished patients, recommending nutritional supplementation for all patients: oral supplementation for non-malnourished patients, and jejunostomy feeding for malnourished patients.
In this context, the primary objective of this study is to evaluate the rate of postoperative complications with perioperative enteral nutrition compared to the absence of preoperative enteral nutrition.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Caroline GRONNIER, PhD, MD
- Phone Number: +335-57-62-24-77
- Email: caroline.gronnier@chu-bordeaux.fr
Study Contact Backup
- Name: Valérie AURILLAC
- Phone Number: +335-57-62-24-77
- Email: valerie.aurillac@chu-bordeaux.fr
Study Locations
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Pessac, France, 33600
- Recruiting
- Hopîtal du Haut Lévêque
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Principal Investigator:
- Caroline GRONNIER, MD, PhD
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Contact:
- Caroline GRONNIER
- Phone Number: + 33 5 57 65 60 05
- Email: caroline.gronnier@chu-bordeaux.fr
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Retrospective case-control study including patients with esophageal cancer treated with neoadjuvant therapy.
The control group consists of patients who did not receive enteral or parenteral nutrition during neoadjuvant treatment.
The case group consists of patients who received enteral or parenteral nutrition during neoadjuvant treatment.
Description
Inclusion Criteria:
- Patient undergoing surgery for esophageal cancer
- Malnourished patient at the time of management
- Receiving neoadjuvant treatment
Exclusion Criteria:
- Patient not malnourished at the time of management
- Patient who did not receive neoadjuvant treatment
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
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Control group
patients who did not receive enteral or parenteral nutrition during neoadjuvant treatment.
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Case group
patients who received enteral or parenteral nutrition during neoadjuvant treatment.
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Patients who did not receive enteral or parenteral nutrition during neoadjuvant treatment.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Rate of postoperative complications according to the Clavien classification
Time Frame: Day 30
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Proportion of patients experiencing at least one postoperative complication, classified according to Clavien-Dindo, in malnourished patients with versus without nutritional support.
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Day 30
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Caroline GRONNIER, MD, PhD, University Hospital, Bordeaux
Publications and helpful links
General Publications
- Mariette C, De Botton ML, Piessen G. Surgery in esophageal and gastric cancer patients: what is the role for nutrition support in your daily practice? Ann Surg Oncol. 2012 Jul;19(7):2128-34. doi: 10.1245/s10434-012-2225-6. Epub 2012 Feb 10.
- Deftereos I, Kiss N, Isenring E, Carter VM, Yeung JM. A systematic review of the effect of preoperative nutrition support on nutritional status and treatment outcomes in upper gastrointestinal cancer resection. Eur J Surg Oncol. 2020 Aug;46(8):1423-1434. doi: 10.1016/j.ejso.2020.04.008. Epub 2020 Apr 18.
- Deftereos I, Yeung JM, Arslan J, Carter VM, Isenring E, Kiss N, On Behalf Of The Nourish Point Prevalence Study Group. Preoperative Nutrition Intervention in Patients Undergoing Resection for Upper Gastrointestinal Cancer: Results from the Multi-Centre NOURISH Point Prevalence Study. Nutrients. 2021 Sep 15;13(9):3205. doi: 10.3390/nu13093205.
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nutrition Disorders
- Neoplasms by Site
- Neoplasms
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Digestive System Diseases
- Gastrointestinal Diseases
- Head and Neck Neoplasms
- Esophageal Diseases
- Nutritional and Metabolic Diseases
- Malnutrition
- Esophageal Neoplasms
- Therapeutics
- Nutrition Therapy
- Feeding Methods
- Nutritional Support
- Parenteral Nutrition
Other Study ID Numbers
- CHUBX 2025/060
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
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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