Role of dietitian support in improving weight loss and nutrition impact symptoms after oesophageal cancer surgery

Abstract

Background Oesophageal cancer is frequently accompanied with malnutrition. We aimed to evaluate if early support from dietitians and patient’s level of satisfaction with the support from dietitians are associated with better outcomes for weight loss and nutrition impact symptoms (NIS). Methods A nationwide and prospective cohort study on patients operated for oesophageal cancer in Sweden from 2013 onwards, included one year after surgery. Study exposures were (1) preoperative dietitian support (yes vs no) and, (2) patient reported satisfaction with dietitian support (high vs low) and outcomes were postoperative (1) percentage weight loss and (2) NIS score (range 0–24); one year after surgery. An ANCOVA model adjusted for predefined confounders was used and presented as mean differences (MD) with 95% confidence intervals (CI). Results Among 245 patients, as many as 57% had received preoperative dietitian support. Preoperative dietitian support was not associated with statistically significant differences in mean postoperative weight loss (MD 0.2 [95% CI −2.6 to 2.9]) and mean NIS score (MD 0.1 [95% CI: −0.8 to 1.0]). Likewise, satisfaction with the dietitian support was not associated with significant differences in mean postoperative weight loss (MD 1.4 [95% CI: −1.5 to 4.3]) and NIS score (MD −0.1 [95% CI: −1 to 0.8]). Conclusions Long-term postoperative weight loss and NIS were not influenced based on whether dietitian support was initiated preoperatively or not and patient’s satisfaction level with dietitian support. Similarity in results may reflect effective screening of malnutrition and dietitian support in centres treating oesophageal cancer in Sweden.