Immunonutrition for Prehabilitation of Patients With Colorectal Cancer Before Surgery (IMNUTPREH-CRC)
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.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
Madrid
-
Madrid, Madrid, Spanien, 28034
- Hospital Universitario Ramon y Cajal
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
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.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: Control
Standard oral nutritional supplements
|
Oral nutritional supplement with high protein content but not enriched with arginine or any other component of immunonutrition
|
|
Eksperimentel: Immunonutrition
Oral nutritional supplements with immunonutrition
|
Oral nutritional supplements with immunonutrition (enriched with arginine, nucleotides, vitamin D and omega-3-fatty acid)
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Post-surgical complications
Tidsramme: 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
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Weight (Kg)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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 (%)
Tidsramme: 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.
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Neurologiske manifestationer
- Sygdomme i nervesystemet
- Neuromuskulære manifestationer
- Neoplasmer efter sted
- Neoplasmer
- Patologiske Tilstande, Anatomiske
- Tarmsygdomme
- Gastrointestinale neoplasmer
- Neoplasmer i fordøjelsessystemet
- Sygdomme i fordøjelsessystemet
- Gastrointestinale sygdomme
- Intestinale neoplasmer
- Endetarmssygdomme
- Tyktarmssygdomme
- Muskelatrofi
- Atrofi
- Patologiske tilstande, tegn og symptomer
- Tegn og symptomer
- Kolorektale neoplasmer
- Sarkopeni
- Mad
- Diæt, mad og ernæring
- Fysiologiske fænomener
- Mad og drikkevarer
- Kosttilskud
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- PI118/22
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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