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.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
-
-
Madrid
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Madrid, Madrid, Spagna, 28034
- Hospital Universitario Ramon y Cajal
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
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.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Comparatore attivo: Control
Standard oral nutritional supplements
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Oral nutritional supplement with high protein content but not enriched with arginine or any other component of immunonutrition
|
|
Sperimentale: Immunonutrition
Oral nutritional supplements with immunonutrition
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Oral nutritional supplements with immunonutrition (enriched with arginine, nucleotides, vitamin D and omega-3-fatty acid)
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Post-surgical complications
Lasso di tempo: 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
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Weight (Kg)
Lasso di tempo: From preoperative evaluation until 90 days after hospital discharge
|
Weight of the patient at each visit
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From preoperative evaluation until 90 days after hospital discharge
|
|
Height (cm)
Lasso di tempo: 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)
Lasso di tempo: 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 (%)
Lasso di tempo: 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.
Lasso di tempo: 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.
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From preoperative evaluation until 90 days after hospital discharge
|
|
Muscle mass - SMMI (cm2/m2)
Lasso di tempo: From preoperative evaluation until 90 days adter surgery
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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)
Lasso di tempo: 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)
Lasso di tempo: 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)
Lasso di tempo: 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
|
Collaboratori e investigatori
Sponsor
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Effettivo)
Completamento primario
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Manifestazioni neurologiche
- Malattie del sistema nervoso
- Manifestazioni neuromuscolari
- Neoplasie per sede
- Neoplasie
- Condizioni patologiche, anatomiche
- Malattie intestinali
- Neoplasie gastrointestinali
- Neoplasie dell'apparato digerente
- Malattie dell'apparato digerente
- Malattie gastrointestinali
- Neoplasie intestinali
- Malattie del retto
- Malattie del colon
- Atrofia muscolare
- Atrofia
- Condizioni patologiche, segni e sintomi
- Segni e sintomi
- Neoplasie colorettali
- Sarcopenia
- Cibo
- Dieta, cibo e nutrizione
- Fenomeni fisiologici
- Cibo e bevande
- Integratori dietetici
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- PI118/22
Piano per i dati dei singoli partecipanti (IPD)
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Descrizione del piano IPD
Informazioni su farmaci e dispositivi, documenti di studio
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