Immunonutrition for Prehabilitation of Patients With Colorectal Cancer Before Surgery (IMNUTPREH-CRC)

June 16, 2026 updated by: Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal

Study of Nutritional Management for Prehabilitation: Surgical and Nutritional Outcomes in Patients With Colorectal Cancer Treated With Oral Nutritional Supplements With and Without Immunonutrition.

Perioperative immunonutrition has been proposed as a strategy to modulate the inflammatory response and improve outcomes after colorectal surgery. However, clinical evidence is heterogeneous, and there are few studies that integrate morbidity outcomes with objective measures of body composition using computed tomography (CT). The objective was to compare immunonutrition versus standard enteral supplementation in surgically treated patients with colorectal cancer, evaluating postoperative complications and changes in body composition.

This study was designed as a 1:1 randomized, open-label, two-arm clinical trial: CONTROL group (standard nutritional oral supplements) and IMMUNONUTRITION (immunonutrition oral supplements). Patients were prescribed these daily oral nutritional supplements at least five days before surgery.

PRIMARY OUTCOME: Post-surgical complications were classified as general and post-surgical; severity was assessed using the Clavien-Dindo classification and global burden with the Comprehensive Complication Index (CCI).

SECONDARY OUTCOMES: Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.

Intragroup changes and the percentage of change between groups were compared. An exploratory analysis was performed in patients with sarcopenia defined by SMMI cut-off points.

HYPOTHESIS:

It is expected that preoperative immunotherapy may result in less post-surgical complications and better body composition.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

56

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
    • Madrid
      • Madrid, Madrid, Spain, 28034
        • Hospital Universitario Ramón y Cajal

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients eligible for colorectal cancer surgery

Exclusion Criteria:

  • Non-surgical colorectal cancer
  • End-stage liver o kidney disease
  • Emergency surgery
  • Previous nutritional supplements
  • Hypersensitivity to arginine, omega-3, or nucleotides
  • Inability for oral nutrition (dysphagia, esophageal/pyloric stenosis)
  • HIV infection
  • Pregnancy
  • Intestinal obstruction
  • Active uncontrolled infection
  • Dementia, advanced degenerative neurological disease.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Control
Standard oral nutritional supplements
Dietary supplement: Standard oral nutritional supplement
Oral nutritional supplement with high protein content but not enriched with arginine or any other component of immunonutrition
Experimental: Immunonutrition
Oral nutritional supplements with immunonutrition
Dietary supplement: Oral nutritional supplement with inmmunonutrition
Oral nutritional supplements with immunonutrition (enriched with arginine, nucleotides, vitamin D and omega-3-fatty acid)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-surgical complications
Time Frame: From surgery until 90 days post-hospital discharge
Complications were classified as general and post-surgical; severity was assessed using the Clavien-Dindo classification and global burden with the Comprehensive Complication Index (CCI).
From surgery until 90 days post-hospital discharge

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Weight (Kg)
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Weight of the patient at each visit
From preoperative evaluation until 90 days after hospital discharge
Height (cm)
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Height of the patient at each visit
From preoperative evaluation until 90 days after hospital discharge
BMI (Kg/m2)
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Body mass index of the patients calculated using weight and height
From preoperative evaluation until 90 days after hospital discharge
Weight loss (%)
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Percentage of weight loss from the preoperative baseline weight of the patient
From preoperative evaluation until 90 days after hospital discharge
MUST (malnutrition universal screening tool) score.
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Nutritional assessment by anthropometric methods including weight, weight loss, height, and body mass index, are used to give the MUST (malnutrition universal screening tool) score.
From preoperative evaluation until 90 days after hospital discharge
Muscle mass - SMMI (cm2/m2)
Time Frame: From preoperative evaluation until 90 days adter surgery
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.
From preoperative evaluation until 90 days adter surgery
Psoas muscle index (cm2/m2)
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area and index, periabdominal musculature, and fat compartments.
From preoperative evaluation until 90 days after hospital discharge
Subcutaneous fat tissue (cm2)
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.
From preoperative evaluation until 90 days after hospital discharge
Visceral fat tissue (cm2)
Time Frame: From preoperative evaluation until 90 days after hospital discharge
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.
From preoperative evaluation until 90 days after hospital discharge

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2024

Primary Completion (Actual)

December 31, 2025

Study Completion (Actual)

March 31, 2026

Study Registration Dates

First Submitted

June 10, 2026

First Submitted That Met QC Criteria

June 16, 2026

First Posted (Actual)

June 17, 2026

Study Record Updates

Last Update Posted (Actual)

June 17, 2026

Last Update Submitted That Met QC Criteria

June 16, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PI118/22

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy/ethical restrictions, as they contain information that could compromise the privacy of research participants.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

Subscribe