Perioperative Oral Nutritional Support For Patients Diagnosed With Primary Colon Adenocarcinoma Undergoing Radical Surgical Procedures -Peri-Nutri Trial: Study Protocol For A Randomized Controlled Trial.

Background: Colon cancer is one of the most common cancers in Finland and worldwide. Cancer-related malnutrition is a well-known risk factor for increased morbidity and mortality after surgery, and it is associated with complications and longer hospitalizations. There are no established recommendations on how to improve the nutritional status of colon cancer patients´ during the perioperative phase. Administration of simple oral nutritional supplements has been suggested to reduce complication rates, but evidence to support this practice is scarce. Methods: and analysis: The Peri-Nutri trial is a prospective, multicenter, randomized, controlled trial. Its primary endpoint is to evaluate whether perioperative oral nutritional support (ONS) decreases the number of complications during the 30-day follow-up after surgery. Secondary endpoints are to study the effect of ONS on quality of life after surgery, length of stay in institutional care, 90-day mortality rate, five-year disease-free survival and overall survival. The patients with a Nutritional risk screening 2002 (NRS-2002) questionnaire result between 2 and 5 (≥3 are classified at risk of malnutrition) will be randomized (1:1 ratio) into either the intervention or control group. The intervention group will receive preoperative ONS two weeks before the operation, and nutritional support will continue 10 days after the operation. The control group will not receive ONS. A total of 318 patients will be randomized into two groups. Ethics/dissemination: The study has been conducted according to the SPIRIT statement. All participants will be signed a written consent form, and the study has been approved by the The Ethics Committee at the Oulu University Hospital. The findings will be presented at international or national conferences and will be published in clinical journals. Trial registration number: ClinicalTrials.gov, NCT03863236, Registered 25 February 2019, https://clinicaltrials.gov/ct2/show/NCT03863236