DOI: 10.1097/01.COT.0000289774.98739.08
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Issn Print: 0276-2234
Publication Date: 2005/05/25
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Excerpt
The number of such patients is quite small and for most, TPN is initiated due to weight loss caused by mechanical gastrointestinal problems, not anorexia, Aminah Jatoi, MD, Associate Professor of Oncology at the Mayo Clinic, and her colleagues found. Nevertheless, home TPN can be associated with long-term survival in these patients.
“A number of organizations in the United States, including the American College of Physicians, advise against the routine use of parenteral nutrition in patients with incurable cancer, and we accept that,” Dr. Jatoi said in an interview.
“Our study was an attempt to say, every now and then there is a patient who is different and maybe needs a different approach. What we found is a very small subset that does benefit. However, the judicious use of home total parenteral nutrition requires a careful clinical assessment on a case-by-case basis.”
Writing in a recent issue of Cancer (2005;103:863–868), Dr. Jatoi and colleagues reported that 16 of 52 patients in their retrospective series survived for at least one year from initiation of home total parenteral nutrition, with one patient still receiving it 12 years later.
The complication rate was acceptable, with 18 catheter infections, four thromboses, three pneumothoraces, and two episodes of TPN-related liver disease, they reported.
The study represents the largest retrospective series of patients with metastatic, incurable cancer who received total parenteral nutrition, Dr. Jatoi said.
