Dietary advice alone or with oral nutritional supplements after hospital discharge in colorectal cancer surgery patients: Five year follow-up of a randomized controlled trial.

OBJECTIVES

The efficacy of dietary advice alone compared to dietary advice supplemented with oral nutritional supplements following hospital discharge in post-cancer surgery patients remains a contentious issue. This study was to assess whether combining dietary advice with oral nutritional supplements improves long-term overall survival and other outcomes, compared with dietary advice alone, in patients following discharge after colorectal cancer surgery.

METHODS

We conducted a 5-year follow-up of a two-arm randomized controlled trial involving colorectal cancer surgery patients at nutritional risk. The control group was offered dietary advice alone, in contrast to the intervention group, which was provided with both oral nutritional supplements and dietary advice. Overall survival was the primary outcome, while secondary outcomes encompassed nonelective hospital readmissions, quality of life, and functional outcomes such as 6-minute walk distance and handgrip strength.

RESULTS

This analysis included 193 patients who completed the 5-year follow-up (97 in the intervention group and 96 in the control group). The intervention group demonstrated a significantly higher overall survival rate compared to the control group for the primary outcome (P = 0.042). The nutritional intervention emerged as a favorable prognostic factor for overall survival, even after adjustment for confounding variables (hazard ratio 0.61, 95% confidence interval 0.38-0.98, P = 0.042). However, the secondary outcomes did not differ significantly between the 2 groups (all P > 0.05).

CONCLUSIONS

Patients with nutritional risk after colorectal cancer surgery who received dietary advice combined with oral nutritional supplements posthospital discharge exhibited improved overall survival compared to those who received dietary advice alone. The results indicate that providing dietary advice combined with oral nutritional supplements may be beneficial for patients after hospital discharge following cancer surgery.