Doctors know that patients who are malnourished before colorectal cancer surgery have more problems after the operation. Some hospitals give patients special nutritional drinks with added ingredients before surgery to help prevent infections and complications. However, doctors aren’t sure if this really works. Researchers are testing whether giving malnourished cancer patients these special drinks for a week before surgery reduces infections and other problems after surgery. They’re studying 176 patients across eight hospitals to see if this targeted nutrition approach actually helps the patients who need it most.

The Quick Take

  • What they studied: Whether giving malnourished colorectal cancer patients special nutritional drinks before surgery reduces infections and complications after surgery
  • Who participated: 176 patients with colorectal cancer who show signs of being malnourished (based on a nutrition screening score), recruited from eight different hospitals
  • Key finding: This is a study plan, not yet completed results. The researchers expect that the special nutrition drinks might reduce infections from 30% down to 12% in malnourished patients
  • What it means for you: If this study shows positive results, malnourished cancer patients might receive special pre-surgery nutrition to help them recover better. However, we need to wait for the actual results before knowing if this approach truly works

The Research Details

This is a carefully planned research study that hasn’t been completed yet. Researchers will divide 176 malnourished colorectal cancer patients into two equal groups. One group will receive 400 milliliters (about 13 ounces) daily of a special nutritional drink containing arginine and omega-3 fatty acids for 7 days before surgery. The other group will eat their normal diet before surgery. Both groups will be followed for 30 days after surgery to see who develops infections or other complications.

The study is happening at eight different hospitals, which helps ensure the results apply to many different patient populations and settings. Researchers carefully selected patients who show signs of malnutrition using a standard screening tool, making this study different from previous research that included all cancer patients regardless of their nutritional status.

This design is important because it focuses specifically on patients who might benefit most from extra nutrition, rather than giving the special drinks to everyone having colorectal cancer surgery.

Previous studies gave special nutritional supplements to all colorectal cancer patients and didn’t find much benefit. This study is different because it focuses only on patients who are already malnourished. The researchers believe that malnourished patients might respond better to nutritional support than patients who are already well-nourished. By targeting the right patients, the study might finally show whether this expensive intervention actually helps.

This is a well-designed study with several strengths: it’s randomized (meaning patients are assigned to groups by chance, not by choice), it includes multiple hospitals (making results more reliable), and it has a clear plan for measuring success. The researchers calculated exactly how many patients they need to prove their point. However, since this is a study protocol (a plan) rather than completed research, we don’t yet have actual results to evaluate.

What the Results Show

This is a study protocol, meaning the research hasn’t been completed yet and no results are available. The researchers are planning to measure whether patients receiving the special nutritional drinks have fewer infections within 30 days after surgery compared to patients eating a normal diet. They expect the special nutrition might reduce infections from 30% (in the control group) to 12% (in the treatment group). The study was registered in April 2023, so results should be available in the coming years.

Beyond infections, researchers will also track: how many total complications patients experience after surgery, how long patients stay in the hospital, how much weight patients lose or gain around surgery time, and changes in blood markers that show nutritional status and immune system function (including proteins like albumin and prealbumin, and inflammation markers).

A previous study by the same research team tested special nutritional drinks in all colorectal cancer patients (not just malnourished ones) and found no benefit for preventing infections. This new study is designed differently because it focuses only on malnourished patients. The researchers believe that malnourished patients are more likely to benefit from nutritional support than patients who are already well-nourished, which is why they’re testing this targeted approach.

Since this is a study plan rather than completed research, we cannot yet evaluate actual limitations. However, potential limitations include: the study only lasts 30 days after surgery (longer-term effects are unknown), it focuses on colorectal cancer specifically (results may not apply to other cancers), and the special nutritional drinks are expensive, so cost may limit their use even if they work.

The Bottom Line

Wait for study results before making decisions. This research is still ongoing. If results show that special pre-surgery nutrition helps malnourished colorectal cancer patients, then malnourished patients scheduled for colorectal cancer surgery should discuss this option with their surgical team. Current evidence is uncertain, which is why this study is being conducted.

This research is most relevant to: malnourished patients scheduled for colorectal cancer surgery, colorectal cancer surgeons and surgical teams, hospital nutritionists, and patients with other types of cancer (though results may not directly apply to them). Patients who are well-nourished before surgery may not benefit from this approach based on previous research.

Results from this study should be available within 2-3 years. If the special nutrition helps, benefits would likely appear within the first month after surgery through reduced infections and faster recovery.

Want to Apply This Research?

  • For malnourished patients awaiting colorectal cancer surgery: track daily nutritional intake (calories, protein, arginine, omega-3 sources) for 7 days before surgery, and monitor for any signs of infection (fever, wound redness, unusual discharge) for 30 days after surgery
  • If prescribed pre-surgery immunonutrition: set daily reminders to consume the full 400 mL nutritional supplement, log consumption in the app, and report any side effects or difficulty tolerating the drink to your surgical team
  • Create a pre-surgery nutrition checklist (7 days before operation), post-surgery symptom tracker (30 days after operation monitoring for fever, wound issues, and energy levels), and weight tracking before and after surgery to measure nutritional changes

This article describes a research study protocol that is still in progress. No final results are yet available. This information is for educational purposes only and should not replace professional medical advice. Patients with colorectal cancer or malnutrition should consult with their doctors, surgeons, and registered dietitians about their individual nutritional needs and pre-surgery preparation. The special nutritional supplements discussed in this study are prescription medical foods that should only be used under medical supervision. Do not start any new supplements or change your diet before surgery without discussing it with your surgical team first.