[Nutritional support as an adjunct to the treatment of upper gastrointestinal cancer patients--esophageal and gastric cancer].

Patients with cancer of the upper gastrointestinal tract such as the esophagus and stomach are malnourished as a result of their cancer-bearing status. In such patients, malnutrition reduces the effects of anti-cancer therapy including surgical treatment. Therefore, we studied the effect of nutritional support in patients with upper gastrointestinal cancer. The incidence of postoperative complications was correlated with the preoperative nutritional status. Thus, improvement of nutritional status by preoperative nutritional support is thought to be important. As metabolic disturbances frequently accompany advanced cancer, the quantity of calories and quality of nutritional regimen were found to be important for improving such metabolic disorders. In the postoperative period, total parenteral nutrition (TPN) prevented the depression of cell-mediated immunity, increased the tolerance to anti-cancer drugs during chemotherapy as an adjunct to surgery, and prolonged the disease-free interval, in patients undergoing absolute non-curative gastrectomy for advanced gastric cancer. The results of chemotherapy were better in recurrent upper gastrointestinal cancer patients whose nutritional parameters were in a favorable range on admission or improved after 2 weeks of TPN.