ReviewESMO open2020
The clinical and cost-effectiveness of supplemental parenteral nutrition in oncology.
Review in ESMO open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Nutrition as prevention for improved cancer health outcomes: a systematic literature review.JNCI cancer spectrum · 2023Pooled it
- Enteral nutrition support in patients with cancer: association of short-term prognosis and medical costs with inflammation.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Trial
- A Cohort Study Protocol of Nutritional Status and Clinical Outcomes in Patients With Common Malignancies (NCOM Study).Food science & nutrition · 2026Article
- Early versus late supplemental parenteral nutrition in gastrointestinal cancer patients undergoing major abdominal surgery: 5-year outcomes from a randomized clinical trial.International journal of surgery (London, England) · 2026Article
- An Examination of Strategies to Improve Access to Medical Nutrition Therapy among Cancer Patients in the United States: A Narrative Review and a Call to Action.Current nutrition reports · 2025Review
- Are Nutritional Interventions Worthwhile in Cancer Patients? A Systematic Review on Economic Evaluation.ClinicoEconomics and outcomes research : CEOR · 2025Review
- The effect of preoperative supplementary parenteral nutrition on nutrition and inflammation in gastric cancer patients.Discover oncology · 2024Article
- Ready-to-Use Multichamber Bags in Home Parenteral Nutrition for Patients with Advanced Cancer: A Single-Center Prospective Study.Nutrients · 2024Article
- SINPE Position Paper on the use of home parenteral nutrition in cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Review
- Supplemental parenteral nutrition in cancer care: why, who, when.Therapeutic advances in medical oncology · 2022Review
- Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical guidelines recommend that parenteral nutrition (PN) is added to enteral nutrition (EN; supplemental parenteral nutrition (SPN)) in order to meet energy and protein needs in patients with cancer when EN alone is insufficient. However, although cancer-related malnutrition is common, there is poor awareness of the value of nutritional care, resulting in SPN being chronically underused.
methodsWe performed a targeted literature review and exploratory cost-utility analysis to gather evidence on the clinical effectiveness of SPN, and to estimate the potential cost-effectiveness of SPN versus EN alone in an example cancer setting.
resultsThe literature review identified studies linking SPN with malnutrition markers, and studies linking malnutrition markers with clinical outcomes. SPN was linked to improvements in body mass index (BMI), fat-free mass, phase angle (PhA) and prealbumin. Of these markers, BMI and PhA were strong predictors of survival. By combining published data, we generated indirect estimates of the overall survival HR associated with SPN; these ranged from 0.80 to 0.99 (mode 0.87). In patients with Stage IV inoperable pancreatic cancer, the incremental cost-effectiveness ratio versus EN alone was estimated to be £41 350 or £91 501 depending on whether nursing and home delivery costs for EN and SPN were combined or provided separately.
conclusionDespite a lack of direct evidence, the results of the literature review demonstrate that SPN may provide important clinical and quality of life benefits to patients with cancer. The potential for any improvement in outcomes in the modelled patient population is very limited, so cost-effectiveness may be greater in patients with less severe disease and other types of cancer.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.