Effects of perioperative eicosapentaenoic acid‑enriched oral nutritional supplement on the long‑term oncological outcomes after total gastrectomy for gastric cancer

Aoyama,Toru; Yoshikawa,Takaki; Ida,Satoshi; Cho,Haruhiko; Sakamaki,Kentaro; Ito,Yuichi; Fujitani,Kazumasa; Takiguchi,Nobuhiro; Kawashima,Yoshiyuki; Nishikawa,Kazuhiro; Nunobe,Soya; Hiki,Naoki

doi:10.3892/ol.2022.13272

Effects of perioperative eicosapentaenoic acid‑enriched oral nutritional supplement on the long‑term oncological outcomes after total gastrectomy for gastric cancer

Authors:
- Toru Aoyama
- Takaki Yoshikawa
- Satoshi Ida
- Haruhiko Cho
- Kentaro Sakamaki
- Yuichi Ito
- Kazumasa Fujitani
- Nobuhiro Takiguchi
- Yoshiyuki Kawashima
- Kazuhiro Nishikawa
- Soya Nunobe
- Naoki Hiki
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Affiliations: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241‑8515, Japan, Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135‑0063, Japan, Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Kanagawa 232‑0024, Japan, Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Aichi 464‑8681, Japan, Department of Surgery, Osaka General Medical Center, Osaka 558‑8558, Japan, Division of Gastroenterological Surgery, Chiba Cancer Center, Chuo-ku, Chiba 260‑8781, Japan, Department of Gastroenterological Surgery, Saitama Cancer Center, Kitaadachi, Saitama 362‑0806, Japan, Department of Surgery, Osaka Medical Center, Osaka 540‑0006, Japan
Published online on: March 15, 2022 https://doi.org/10.3892/ol.2022.13272
Article Number: 151
Copyright: © Aoyama et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Basic and clinical reports have suggested that eicosapentaenoic acid (EPA) exhibits anti‑tumor activity. The present study evaluated whether perioperative EPA could improve the survival of patients with localized gastric cancer as a key secondary endpoint of a randomized clinical study. The present study was designed as multicenter, open‑label, superiority, randomized trial to confirm the preventive effect of EPA on body weight loss after total gastrectomy for gastric cancer. Eligible patients were randomized to either the standard‑diet group (EPA‑off group) or EPA‑on group by a centralized dynamic method. An EPA‑enriched supplement (ProSure®) was given to the EPA‑on group in addition to their standard diet. This supplement included 600 kcal with 2.2 g/day of EPA. Among the 126 patients who were randomized, 123 patients (EPA‑off group, n=60; EPA‑on group, n=63) were examined in the survival analyses. All background factors were well balanced between the two groups. The 3‑year and 5‑year overall survival rates were 74.6 and 67.8%, respectively, in the EPA‑off group, and 77.8 and 76.2% in the EPA‑on group. There was no significant difference between the EPA‑off and EPA‑on groups (hazard ratio, 0.77; P=0.424). In the subgroup analysis, the hazard ratio was 0.39 in patients who received neoadjuvant chemotherapy and 0.57 in patients with nodal metastasis. In conclusion, a clear survival benefit of perioperative EPA was not observed in localized gastric cancer. The value of EPA should be further tested in a future study in patients with unfavorable advanced gastric cancer. Clinical trial number: UMIN000006380; date of registration, September 21, 2011.

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