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Open AccessArticle

The Advantages of Clinical Nutrition Use in Oncologic Patients in Italy: Real World Insights

1
Medical Oncology Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
2
Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
3
Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, 10126 Turin, Italy
4
Clicon S.r.l., Health Economics and Outcomes Research, 48121 Ravenna, Italy
5
Medical Oncology Unit, AOU Careggi, 50134 Firenze, Italy
6
Clinical Nutrition Unit Fondazione IRCCS Istituto Tumori Milano, 20133 Milan, Italy
7
Humanitas Clinical and Research Center IRCCS, Rozzano and Humanitas University, 20089 Milan, Italy
8
Medical Oncology Unit, Clinical Cancer Centre IRCCS—AUSL Reggio Emilia, 42122 Reggio Emilia, Italy
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this work.
Healthcare 2020, 8(2), 125; https://doi.org/10.3390/healthcare8020125
Received: 23 March 2020 / Revised: 27 April 2020 / Accepted: 1 May 2020 / Published: 6 May 2020
(This article belongs to the Special Issue Artificial Nutrition in Cancer Patients)
This retrospective observational study aimed to provide insights on the use of clinical nutrition (CN) (enteral and parenteral feeding) and outcomes in an Italian real-world setting. The data source comes from administrative databases of 10 Italian Local Health Units. Patients diagnosed with malignant neoplasms from 1 January 2010 to 31 December 2015 were included. Metastasis presence was ascertained by discharge diagnosis in the hospitalization database. CN was identified by specific codes from pharmaceutical and hospitalization databases. Two cohorts were created—one for metastatic patients (N = 53,042), and one for non-metastatic patients (N = 4379) receiving CN. Two survival analyses were set for the cohort of metastatic patients—one included patients receiving CN and the second included malnourished patients. Our findings show that (1) administration of CN is associated with positive survival outcomes in metastatic patients with gastrointestinal, respiratory, and genitourinary cancer; (2) CN in malnourished metastatic patients with gastrointestinal and genitourinary cancer was associated with significant improvement in survival; (3) early administration of CN was associated with improvement in survival in non-metastatic patients with gastrointestinal cancer (HR 95%CI: 0.5 (0.4–0.6), p-value < 0.05). This study highlights the need to improve the assessment of nutritional status in oncologic patients and suggests a potential survival benefit of CN treatment in metastatic disease. View Full-Text
Keywords: clinical nutrition; malnutrition; metastasis; oncology; real-world clinical nutrition; malnutrition; metastasis; oncology; real-world
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Pedrazzoli, P.; Caccialanza, R.; Cotogni, P.; Degli Esposti, L.; Perrone, V.; Sangiorgi, D.; Di Costanzo, F.; Gavazzi, C.; Santoro, A.; Pinto, C. The Advantages of Clinical Nutrition Use in Oncologic Patients in Italy: Real World Insights. Healthcare 2020, 8, 125.

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