Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival

Background Plasma arginine concentrations are lower in patients with cancer which indicates that arginine metabolism may be disturbed in these patients A ginine supplementation has been associated with positive effects on antitumor mechanisms and has been shown to reduce tumor growth and to prolong survival Furthermore the prognosis of patients with head and neck cancer remains disappointing Insufficient intake frequently leads to malnutrition which contributes to high morbidity and mortality rates Objective The aim of this study was to assess the long term effects of perioperative arginine supplementation in severely malnourished patients with head and neck cancel Design In this double blind randomized, controlled trial we randomly assigned 32 severely malnourished patients with head and neck cancer to receive 1) standard perioperative enteral nutrition (n = 15) or 2) arginine supplemented perioperative enteral nutrition (n = 17) The primary outcome was long term (>= 10 y) survival Secondary outcomes included the long term appearance of locoregional recurrence distant metastases and second primary tumors Results No significant differences in baseline characteristics were observed between groups The group Teeming arginine-enriched nutrition h id a significantly better over ill survival (P = 0 019) and better disease specific survival (P = 0 022) Furthermore the arginine supplemented group had significantly better locoregional recurrence free survival (P = 0 027) No significant difference in the occurrence of distant metastases or occurrence of a second primary tumor was observed between the groups Conclusion Perioperative arginine enriched enteral nutrition significantly improved the long-term overall survival and long-term disease specific survival in malnourished patients with held and neck cancer Am J Clin Nutr 2010 92 1151-6