Fish Oil Enhances T Cell Function and Tumor Infiltration and Is Correlated With a Cancer Prevention Effect in HER-2/neu But Not PyMT Transgenic Mice [Effect of immune-enhanced enteral diet on postoperative immunological function in patients with colorectal cancer]. Effects of oils rich in eicosapentaenoic and docosahexaenoic acids on immune cell composition and function in healthy humans. Role of enteral immunonutrition in patients with gastric carcinoma undergoing major surgery. Prospective double-blind randomized study on the efficacy and safety of an n-3 fatty acid enriched intravenous fat emulsion in postsurgical gastric and colorectal cancer patients Leukocyte numbers and function in subjects eating n-3 enriched foods: selective depression of natural killer cell levels Comparison between the AA/EPA ratio in depressed and non depressed elderly females: omega-3 fatty acid supplementation correlates with improved symptoms but does not change immunological parameters A prospective, randomized, controlled study of ω-3 fish oil fat emulsion-based parenteral nutrition for patients following surgical resection of gastric tumors Enteral immuno-enhanced diets with arginine are safe and beneficial for patients early after esophageal cancer surgery. Fatty acid patterns and risk of prostate cancer in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: a phase II trial Perioperative Immunonutrition in Well-Nourished Patients Undergoing Surgery for Head and Neck Cancer: Evaluation of Inflammatory and Immunologic Outcomes Clinical and Immunological Impact of Early Postoperative Enteral Immunonutrition After Total Gastrectomy in Gastric Cancer Patients: A Prospective Randomized Study Immunonutrition improves functional capacities in head and neck and esophageal cancer patients undergoing radiochemotherapy: a randomized clinical trial. Omega-3 fatty acid-, micronutrient-, and probiotic-enriched nutrition helps body weight stabilization in head and neck cancer cachexia. Enteral Nutrition Enriched With Eicosapentaenoic Acid (EPA) Preserves Lean Body Mass Following Esophageal Cancer Surgery: Results of a Double-Blinded Randomized Controlled Trial Impact of fish oil enriched total parenteral nutrition on elderly patients after colorectal cancer surgery.
Few studies have explored the effects of omega-3 polyunsaturated fatty acid ( n-3 PUFA ) supplementation on immune modulation in murine models of mammary carcinogenesis . HER-2/neu and PyMT mice were r and omized to 2 dietary interventions : AIN-93G-based diet with 1 ) 11 % of diet ( per gram weight ) as corn oil ( CO ) or 2 ) 10 % of diet as menhaden fish oil plus 1 % of diet as corn oil ( FO ) . FO significantly reduced the incidence and multiplicity of tumors ( P < 0.001 ) in HER-2/neu , but not PyMT mice . FO-fed mice had significantly larger splenocyte counts than CO-fed mice in both the HER-2/neu and PyMT models ; and in both models this was comprised of an increase in most cell types , including Gr-1+/CD11b+ cells . T cells from FO-fed HER-2/neu mice produced significantly more interleukin-2 ( P = 0.004 ) and interferon-γ ( P = 0.012 ) in response to in vitro stimulation with anti-CD3 ( 0.5 µg/ml ) . Lastly , FO-fed HER-2/neu mice had significantly more tumor immune infiltrates than CO-fed mice , including NK1.1 + , F4/80 + , and Gr-1+/CD11b+ cells ( P ≤ 0.05 ) . Greater Th1 cytokine production and significantly more tumor immune infiltrates in FO-fed Her2/neu mice may account for the cancer prevention effect of fish oil in this model OBJECTIVE To explore the influence of immune-enhanced enteral diet on postoperative metabolism and immunological function in colorectal tumor patient . METHODS Seventy-two patients with colorectal cancer were enrolled in this study . Immune-enhanced enteral diet was administrated in 36 cases ( study group ) , while regular enteral nutrition ( EN ) was given in 36 cases ( control group ) . The immunological function , inflammatory function and nutrition index were evaluated before operation and on postoperative day 1 and day 8 . RESULTS Serum levels of glutamine , asparagines , CD4 ( + ) , NK , IgG , IgM were higher in the study group than those in the control group . The levels of IL- 6 , TNF-alpha in the study group were lower than those in the control group . The difference was statistically significant ( P < 0.05 ) . CONCLUSIONS Immune-enhanced enteral diet can ameliorate the cell immunological and fluid immunological function in the patients with colorectal cancer after the procedures BACKGROUND Supplementation of the diet with fish oil , which is rich in the long-chain n-3 polyunsaturated fatty acids eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) , is reported to decrease several markers of immune function . However , whether EPA , DHA , or a combination of the 2 exerts these immunomodulatory effects is unclear . OBJECTIVE The objective of the study was to determine the effects of supplementation with an EPA-rich or DHA-rich oil on a range of immune outcomes representing key functions of human neutrophils , monocytes , and lymphocytes in healthy humans . DESIGN In a placebo-controlled , double-blind , parallel study , 42 healthy subjects were r and omly allocated to receive supplementation with either placebo ( olive oil ) , EPA ( 4.7 g/d ) , or DHA ( 4.9 g/d ) for 4 wk . Blood sample s were taken before and after supplementation . RESULTS The fatty acid composition of plasma phospholipids and neutrophils was dramatically altered by supplementation with EPA or DHA , and the effects of EPA differed notably from those of DHA . DHA supplementation decreased T lymphocyte activation , as assessed by expression of CD69 , whereas EPA supplementation had no significant effect . Neither the EPA-rich oil nor the DHA-rich oil had any significant effect on monocyte or neutrophil phagocytosis or on cytokine production or adhesion molecule expression by peripheral blood mononuclear cells . CONCLUSIONS Supplementation with DHA , but not with EPA , suppresses T lymphocyte activation , as assessed by expression of CD69 . EPA alone does not , therefore , influence CD69 expression . No other marker of immune function assessed in this study was significantly affected by either EPA or DHA OBJECTIVE To evaluate the influence of postoperative immunonutrition on immune and nutritional parameters in patients with gastric carcinoma . METHODS From September 2002 to August 2003 , 40 patients with gastric carcinoma who had undergone major surgery were r and omly divided into an immunonutrition group and st and ard nutrition group , each of 20 patients . On postoperative Day 2 , patients in the st and ard nutrition group received a st and ard enteral formula , while those in the immunonutrition group received an enteral formula enriched with glutamine , arginine and omega-3 fatty acids . Nutritional support was continued for 7 days . Blood sample s were obtained to determine plasma albumin , prealbumin and transferrin on Days 0 , 5 and 9 . On Days 0 , 1 and 9 , blood sample s were collected to detect immunoglobulin ( Ig ) A , IgG , IgM , CD4 and CD8 cell counts , the ratio of CD4/CD8 , interleukin (IL)-2 , IL-6 and tumour necrosis factor (TNF)-alpha , respectively . RESULTS There were no significant differences between the two groups in protein and immune parameters preoperatively and no significant differences in management perioperatively . No serious adverse effects were recorded with the two formulas . Postoperative procedures were smooth in both groups . On Day 9 , serum levels of prealbumin and transferrin were higher in the immunonutrition group than in the st and ard nutrition group ( p<0.01 ) . After 7 days ' nutritional support , patients in the immunonutrition group had higher levels of immunoglobulin , CD4 cell counts , CD4/CD8 ratio and IL-2 than those in the control group , whereas IL-6 and TNF-alpha levels were significantly lower in the immunonutrition group . CONCLUSION Compared with st and ard enteral nutrition , enteral immunonutrition can improve defence mechanisms and modulate inflammatory action after major elective surgery for gastric carcinoma Abstract Background A lipid emulsion composed of soybean oil ( long-chain triglycerides , LCT ) , medium-chain triglycerides ( MCT ) and n-3 poly-unsaturated fatty acids ( PUFAs ) was evaluated for immune-modulation efficacy , safety , and tolerance in patients undergoing major surgery for gastric and colorectal cancer . Methods In a prospect i ve , r and omized , double-blind study , 99 patients with gastric and colorectal cancer receiving elective surgery were recruited and r and omly assigned to either the study group , receiving the n-3 PUFAs enriched intravenous fat emulsion ( IVFE ) , or the control group , receiving a lipid emulsion comprised of soybean oil and MCTs ( 0.8 – 1.5 g · kg-1 · day-1 ) as part of total parenteral nutrition ( TPN ) regimen from surgery ( day -1 ) up to post-operative day 7 . Safety and efficacy parameters were assessed on day -1 and post-operative visits on day 1 , 3 , and 7 . Adverse events were documented daily and compared between the groups . Results Pro-inflammatory markers , laboratory parameters , and adverse events did not differ prominently between the 2 groups , with the exception of net changes ( day 7 minus day -1 ) of free fatty acids ( FFAs ) , triglyceride , and high-density lipoprotein ( HDL ) . Net decrease of FFAs was remarkably higher in the study group , while the net increase of triglyceride and decrease of HDL was significantly lower . Conclusions The n-3 PUFA-enriched IVFE showed improvements in lipid metabolism . In respect of efficacy , safety and tolerance both IVFE were comparable . In patients with severe stress , there is an inflammation-attenuating effect of n-3 PUFAs . Further , adequately powered clinical trials will be necessary to address this question in postsurgical GI cancer patients .Trial registration US Clinical Trials.gov NCT00798447 Introduction While consumption of omega-3 long-chain polyunsaturated fatty acids ( n-3 LCPUFA ) has been recommended for those at risk of inflammatory disease such as rheumatoid arthritis , the mechanism of their anti-inflammatory effect remains to be clearly defined , particularly in relation to the dose and type of n-3 LCPUFA . The objective of this study was to determine whether varying the levels of n-3 LCPUFA in erythrocyte membrane lipids , following dietary supplementation , is associated with altered numbers and function of circulating leukocytes conducive to protection against inflammation . Methods In a double-blind and placebo-controlled study , 44 healthy subjects aged 23 to 63 years consumed either st and ard or n-3 LCPUFA-enriched versions of typical processed foods , the latter allowing a target daily consumption of 1 gram n-3 LCPUFA . After six months , peripheral blood leukocyte and sub population proportions and numbers were assessed by flow cytometry . Leukocytes were also examined for lymphoproliferation and cytokine production , neutrophil chemotaxis , chemokinesis , bactericidal , adherence and iodination activity . Erythrocytes were analyzed for fatty-acid content . Results Erythrocyte n-3 LCPUFA levels were higher and absolute leukocyte and lymphocyte numbers were lower in subjects consuming n-3 enriched foods than in controls . There were no changes in the number of neutrophils , monocytes , T cells ( CD3 + ) , T-cell subsets ( CD4 + , CD8 + ) and B cells ( CD19 + ) . However , natural killer ( NK ) ( CD3-CD16+CD56 + ) cell numbers were lower in n-3 supplemented subjects than in controls and were inversely related to the amount of eicosapentaenoic acid or docosahexaenoic acid in erythrocytes . No significant correlations were found with respect to lymphocyte lymphoproliferation and production of IFN-γ and IL-2 , but lymphotoxin production was higher with greater n-3 LCPUFA membrane content . Similarly , neutrophil chemotaxis , chemokinesis , bactericidal activity and adherence did not vary with changes in erythrocyte n-3 LCPUFA levels , but the iodination reaction was reduced with higher n-3 LCPUFA content . Conclusion The data show that regular long-term consumption of n-3 enriched foods leads to lower numbers of NK cells and neutrophil iodination activity but higher lymphotoxin production by lymphocytes . These changes are consistent with decreased inflammatory reaction and tissue damage seen in patients with inflammatory disorders receiving  n-3 LCPUFA  supplementation Background Depression is one of the most frequently missed diagnoses in elderly people , with obvious negative effects on quality of life . Various studies have shown that long chain omega-3 polyunsaturated fatty acids ( n-3 PUFA ) may be useful in its management . Our objective was to evaluate whether a supplement containing n-3 PUFA improves depressive symptoms in depressed elderly patients , and whether the blood fatty acid pattern is correlated with these changes . Methods The severity of depressive symptoms according to the Geriatric Depression Scale ( GDS ) , blood fatty acid composition and erythrocyte phospholipids were analyzed in 46 depressed females aged 66 - 95y , diagnosed with depression according to DSMIV , within the context of a r and omized , double-blind , placebo-controlled trial . 22 depressed females were included in the intervention group ( 2.5 g/day of n-3 PUFA for 8 weeks ) , and 24 in the  placebo  group . We also measured immunological parameters ( CD2 , CD3 , CD4 , CD8 , CD16 , CD19 and cytokines ( IL-5 , IL-15 ) . Results The mean GDS score and AA/EPA ratio , in whole blood and RBC membrane phospholipids , were significantly lower after 2 months supplementation with n-3 PUFA . A significant correlation between the amelioration of GDS and the AA/EPA ratio with some immunological parameters , such as CD2 , CD19 , CD4 , CD16 and the ratio CD4/CD8 , was also found . Nevertheless , omega-3 supplementation did not significantly improve the studied immunological functions . Conclusions n-3 PUFA supplementation ameliorates symptoms in elderly depression . The n-3 PUFA status may be monitored by means of the determination of whole blood AA/EPA ratio Background Nutrients such as ω-3 fatty acids including fish oil components eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) suppress the growth and promote apoptosis of tumor cells , improve immune function and reduce the effects of systemic inflammatory response syndrome . We sought to investigate the effect of ω-3 fish oil fat emulsion-based parenteral nutrition ( PN ) on nutritional state , immune function , inflammatory reaction , expression of tumor factors and complication incidence in patients after surgical resection of gastric cancer . Methods Forty-eight patients after surgical operation of gastric tumor in hospital were r and omly divided into the control group and intervention group . Patients in both groups were treated with iso-nitrogen and iso-caloric parenteral nutrition support . In addition , the intervention group received ω-3 fish oil fat emulsion and the control group received soybean oil . The indicators of nutrition , immune function and inflammation in the two groups were detected on the day before the operation and postoperative day 6 . The rate of complication was compared between the two groups . Results There was no significant difference in nutritional state , liver function and renal function between the two groups ( P > 0.05 ) . However , the levels of inflammatory markers were significantly decreased ( P < 0.01 ) , and the rate of complication was also decreased in the intervention group as compared with the control group . Conclusions ω-3 fish oil fat emulsion-based parenteral nutrition alleviates the inflammatory reaction and reduces the rate of inflammatory complications We previously reported that provision of immediate enteral nutrition ( EN ) with a certain amount of omega (omega)-3 fatty acids ( FAs ) in patients after esophageal cancer surgery result ed in reduced platelet aggregation , coagulation activity , and cytokine production . We investigated whether EN using immuno-enhanced diet ( IED ) containing a large amount of omega-3 FAs as well as arginine and RNA affected the above-described responses . We also attempted to reveal whether arginine in the IED can potentially harm patients who undergo esophageal cancer surgery . Twenty-nine patients with esophageal cancer who underwent similar surgical procedures were selected . All patients received EN starting immediately after surgery . Fourteen patients received the formula with fewer omega-3 FAs , and fifteen patients received the IED . Administration of the IED tended to inhibit postoperative decrease in platelet count . Prothrombin activity and thrombin-antithrombin III complex levels were significantly reduced in the IED group . Plasma IL-8 levels were significantly lower ( P < 0.05 ) in patients without the IED on the fifth postoperative day ( POD ) . The proportion of T-cells was significantly higher ( P < 0.05 ) in the IED group on PODs 1 and 7 . Nitrate/nitrite levels did not differ significantly between the two groups . Early EN with an IED may enhance the inhibitory effects on postoperative platelet aggregation and hypercoagulation , and appeared to be advantageous to T-cell proliferation . These effects are expected to be beneficial in patients at risk of developing infectious complications . This study also showed that the IED could be safely used without any adverse effects for patients early after a radical surgery for the esophageal cancer BACKGROUND Fatty acids in blood may be related to the risk of prostate cancer , but epidemiologic evidence is inconsistent . Blood fatty acids are correlated through shared food sources and common endogenous desaturation and elongation pathways . Studies of individual fatty acids can not take this into account , but pattern analysis can . Treelet transform ( TT ) is a novel method that uses data correlation structures to derive sparse factors that explain variation . OBJECTIVE The objective was to gain further insight in the association between plasma fatty acids and risk of prostate cancer by applying TT to take data correlations into account . DESIGN We reanalyzed previously published data from a case-control study of prostate cancer nested within the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) cohort . TT was used to derive factors explaining the variation in 26 plasma phospholipid fatty acids of 962 incident prostate cancer cases matched to 1061 controls . Multiple imputation was used to deal with missing data in covariates . ORs of prostate cancer according to factor scores were determined by using multivariable conditional logistic regression . RESULTS Four simple factors explained 38 % of the variation in plasma fatty acids . A high score on a factor reflecting a long-chain n-3 PUFA pattern was associated with greater risk of prostate cancer ( OR for highest compared with lowest quintile : 1.36 ; 95 % CI : 0.99 , 1.86 ; P-trend = 0.041 ) . CONCLUSION Pattern analyses using TT groupings of correlated fatty acids indicate that intake or metabolism of long-chain n-3 PUFAs may be relevant to prostate cancer etiology Goals The aim of the study was to assess the impact of an eicosapentanoic acid-containing protein and energy dense oral nutritional supplement ( EPA-ONS ) on nutritional and inflammatory status , quality of life ( QOL ) , plasma phospholipids ( PPL ) and cytokine profile , tolerance of irinotecan-containing chemotherapy and EPA-ONS in patients with advanced colorectal cancer ( CRC ) receiving chemotherapy . Material s and methods Patients with advanced CRC having one prior chemotherapy regimen received 480 ml of EPA-ONS daily for 3 weeks before commencing chemotherapy with folinic acid , 5-fluorouracil , irinotecan ( FOLFIRI ) , and continued for 3 cycles of treatment ( 9 weeks ) . All assessment s including weight , body composition , C-reactive protein ( CRP ) , QOL , dietary intake , PPL and cytokine analyses were performed at baseline , 3 and 9 weeks . Results Twenty-three patients were enrolled , 20 completed 3 weeks , and 15 completed 9 weeks . The mean EPA-ONS intake was 1.7 tetrapaks ( 408 ml ) daily . There was a significant increase in mean weight ( 2.5 kg ) at 3 weeks ( p = 0.03 ) . Lean body mass ( LBM ) was maintained . Protein and energy intake significantly decreased after the commencement of chemotherapy ( protein p = 0.003 , energy p = 0.02 ) . There was a significant increase in energy levels ( p = 0.03 ) , whilst all other QOL measures were maintained . PPL EPA levels increased significantly over the first 3 weeks . Mean CRP increased by 14.9 mg/L over the first 3 weeks ( p = 0.004 ) , but decreased to baseline levels by the end of the trial . There was a significant correlation between plasma IL-6 and IL-10 concentrations and survival , and between IL-12 and toxicity . Conclusion Dietary counseling and the provision of EPA-ONS may result in maintenance of nutritional status and QOL , however r and omized trials are required to evaluate the impact of EPA on toxicity from chemotherapy Limited work is available on the benefits of nutritional support enriched with arginine and n-3 fatty acids in surgical patients with head and neck cancer , particularly if well-nourished . We conducted a pilot study in these patients to examine effects on inflammatory markers and clinical outcome . Patients scheduled for radical resection of the oral cavity were r and omised to 5 day preoperative and 5 day postoperative Impact ® ( IMN , n = 4 ) , or no preoperative supplementary nutrition and Iso source ® postoperatively ( STD , n = 4 ) . Plasma fatty acids , C-reactive protein ( CRP ) , tumour necrosis factor (TNF)-α , interleukin (IL)-6 and IL-10 were measured at baseline , day of surgery and on postoperative days ( POD ) 2 , 4 and 10 . Postoperative complications were recorded . The ( eicosapentaenoic acid plus docosahexaenoic acid ) to arachidonic acid ratio was significantly higher in IMN patients on POD 2 , 4 and 10 ( P < 0.01 ) . While not statistically significant , CRP , TNF-α , and IL-6 concentrations were higher in the STD group on POD2 while IL-10 was lower . Median length of stay was 10 ( range 10–43 ) days in the IMN group and 21.5 ( 7–24 ) days in the STD group . Five complications were seen in the STD group and two in the IMN group . The results support the need for a larger trial focusing on clinical outcome Background Enteral immunodiet has been gaining increasing attention , but experimental data of its clinical effects in patients with gastric cancer are inconsistent , contradictory , and poorly investigated . The aim of this study was to assess the impact of early postoperative enteral immunonutrition on clinical and immunological outcomes in a homogeneous group of gastric cancer patients su bmi tted to total gastrectomy . Methods A total of 109 patients with gastric cancer were r and omized to receive early postoperative enteral immunonutrition ( formula supplemented with arginine , omega-3 fatty acids and ribonucleic acid [ RNA ] ) , or an isocaloric – isonitrogenous control . The postoperative outcome was evaluated based on clinical variables , including postoperative infectious complications , anastomotic leak rate , and length of hospitalization . In addition , state of cellular immunity was evaluated and compared between the 2 groups . Results The incidence of postoperative infectious complications in the immunodiet group ( 7.4 % ) was significantly ( p < .05 ) lower than that of the control group ( 20 % ) , as well as the anastomotic leak rate ( 3.7 % in immunodiet group vs 7.3 % in st and ard nutrition group , p < .05 ) . Mortality rate did not show any significant differences ; patients of the immunodiet group were found to have a significantly reduced length of hospitalization ( 12.7 ± 2.3 days ) when compared with st and ard diet group ( 15.9 ± 3.4 days , p = .029 ) . The data on cellular immunity showed that the postoperative CD4 + T-cell counts decreased in both groups , but the reduction in the IED group was significantly higher ( p = .032 ) compared with the SND group . Conclusions Early postoperative enteral immunonutrition significantly improves clinical and immunological outcomes in patients undergoing gastrectomy for gastric cancer BACKGROUND & AIMS Malnutrition is frequent in head and neck ( HN ) and esophageal cancer patients and aggravated by radiochemotherapy ( RCT ) , increasing morbi-mortality and treatment toxicity . Our goal was to investigate the effect of immunonutrition consisting of an arginine , omega-3 fatty acid , nucleotides-enriched diet on nutritional status , and functional capacity in HN or esophageal cancer patients undergoing RCT . METHODS 37 patients were r and omized in a double-blind clinical trial . 5 days before and until the end of RCT ( 5 - 7 weeks ) , they received either an Immunomodulating Enteral Nutrition ( IEN ) or an isonitrogenous , isoenergetic St and ard Enteral Nutrition ( SEN ) .  Anthropometrical parameters , nutritional risk index ( NRI ) , serum albumin , plasma antioxidant capacity , and functional capacity were recorded between the beginning and the end of RCT . RESULTS A significant gain in total body weight ( + 2.1 ± 3.1 kg ) was observed in IEN patients . Albuminemia and NRI were improved concomitantly in IEN malnourished patients . Plasma antioxidant capacity was improved ( + 100 ± 13 μM EqTrolox ) in IEN patients . Functional capacity measured by WHO Performance Status and Karnofsky index was maintained in IEN patients but significantly reduced in SEN patients . CONCLUSIONS These preliminary data show that immunonutrition could improve the nutritional status together with functional capacity in HN and esophageal cancer patients undergoing RCT . CLINICAL TRIAL REGISTRATION This clinical trial promoted by the University Hospital Center of Clermont-Ferr and has been registered at Clinical Trial.gov website under the following reference : NCT00333099 OBJECTIVE To evaluate whether an oral nutritional supplement enriched with omega-3 fatty acids , micronutrients , and probiotics affected body weight ( BW ) changes , serum albumin and prealbumin levels in patients with head and neck cancer ( HNC ) cachexia . STUDY DESIGN Sixty-eight HNC patients were r and omly assigned to receive either an Ethanwell/Ethanzyme ( EE ) regimen enriched with omega-3 fatty acids , micronutrients , and probiotics , or control ( Isocal ) for a 3-month period . Analysis of covariance was used to examine the association between BW change and variables . RESULTS Patients with body mass index ( BMI ) < 19 and those receiving the EE regimen consumed fewer daily calories but showed significantly increased BW and maintained higher serum albumin and prealbumin levels than other patients ( P<.05 ) . Their BW changes were significantly associated with changes in serum albumin and prealbumin levels . CONCLUSIONS EE regimen improved BW as well as serum albumin and prealbumin levels in HNC patients with BMI < 19 Background : Esophagectomy represents an exemplar of controlled major trauma , with marked metabolic , immunologic , and physiologic changes as well as an associated high incidence of complications . Eicosapentaenoic acid ( EPA ) enriched enteral nutrition ( EN ) modulates immune function and limits catabolism in patients with advanced cancer , but its impact in the peri-operative period is unclear . Objectives : To examine the effects of perioperative EPA enriched EN on the metabolic , nutritional , and immuno-inflammatory response to esophagectomy , and on postoperative complications . Methods : In a double-blind design , patients were r and omized to a st and ard EN formula or a formula enriched with 2.2 g EPA/d for 5 days preoperatively ( orally ) and 21 days postoperatively ( jejunostomy ) . Segmental bioelectrical impedance analysis was performed preoperatively and on POD 21 . Postoperative complications were monitored , as well as the acute phase response , coagulation markers , and serum cytokines . Results : Fifty-three patients ( 28 EPA , 25 st and ard ) completed the study , and both groups were well matched . Serum and peripheral blood mononuclear cell ( P BMC ) membrane EPA levels were significantly increased in the EPA group . There was no difference in the incidence of major complications . The EPA group maintained all aspects of body composition postoperatively , whereas patients in the st and ard EN group lost significant amounts of fat-free mass ( 1.9 kg , P = 0.030 ) compared with the EPA group [ leg ( 0.3 kg , P = 0.05 ) , arm ( 0.17 kg , P = 0.01 ) , and trunk ( 1.44 kg , P = 0.03 ) ] . The EPA group had a significantly ( P < 0.05 ) attenuated stress response for TNFα , IL-10 , and IL-8 compared with the st and ard group . Conclusions : EPA supplemented early EN is associated with preservation of lean body mass post esophagectomy compared with a st and ard EN . These properties may merit longer-term study to address its impact on recovery of function and quality of life in models of complex surgery or multimodal cancer treatment regimens BACKGROUND Polyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes . The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery . METHODS Fifty-seven elderly patients with colorectal cancer were enrolled in this prospect i ve , r and omized , double-blind , controlled clinical trial . All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion ( 20 - 24 hours per day ) for seven days after surgery . The control group ( n = 28 ) received 1.2 g/kg soybean oil per day , whereas the treatment group ( n = 29 ) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day . Blood sample s were taken pre-operatively , and at days one and eight after the operation . The plasma levels of CD4 , CD8 , CD4/CD8 , interleukin 6 ( IL-6 ) and tumor necrosis factor α ( TNF-α ) were measured . Clinical outcomes were then analysed . RESULTS Patient characteristics were comparable between the two groups . At day eight post-surgery , IL-6 , TNF-α and CD8 titres were lower in the treatment group when compared to the control group ; these results reached statistical significance . In the treatment group , there were fewer infectious complications and incidences of systemic inflammatory response syndrome ( SIRS ) , and shorter lengths of hospital stay were observed . The total cost of medical care was comparable for the two groups . No serious adverse events occurred in either group . CONCLUSIONS Fish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes
Background Surgical resection remains the primary treatment for gastrointestinal ( GI ) malignancy including early-stage cancer .
Omega-3 polyunsaturated fatty acids ( n-3 PUFAs ) have been reported to have beneficial clinical and immune-modulating effects in the prognosis of GI cancer patients undergoing surgery .