Background: Eicosapentaenoic acid (EPA) containing nutritional supplement can reverse weight loss and increase lean body mass in a perioperative period of head and neck cancer patients. There is no randomized study to clinically compare an EPA-enriched supplement over a conventional supplement in head and neck cancer patients. Thus the aim of this study was to compare an EPA-enriched supplement with a conventional supplement in malnourished head and neck cancer patients following surgery. The primary outcome of this study was defined as perioperative weight changes, with postoperative complications a secondary outcome.

Methods: The patients were stratified into 4 groups based on the extent of their surgery: primary tumor resection or neck dissection, primary tumor resection and neck dissection, primary tumor resection and flap reconstruction, and primary tumor resection and neck dissection and flap reconstruction. Pretreatment randomization was conducted in each stratified group for the selection of nutritional supplement, whether EPA-enriched or standard formula. The supplements were prescribed 7 days preoperative through 14 days postoperative. Body weight and composition including serum parameters were measured from 7 days preoperative until 4 months postoperative. The hospitalized courses were recorded.

Results: Thirty-one patients in each group consumed EPA-enriched and standard formula supplements. There were no significant body weight or composition changes perioperatively. From 7 days before surgery to 4 months after surgery, mean body weight reduced by 2.95 (SD 4.70) kg and 2.82 (SD 4.78) kg in the EPA-enriched and standard formula groups, respectively. The mean overall patient weight loss was 2.89 kg or 5% throughout the period of study. No significant differences in lean body mass and body composition changes from the beginning to the end of the study were observed between the groups. No significant differences in the hospitalized days and postoperative complications were observed.

Conclusions: Body weight changes in malnourished head and neck cancer patients following surgery were not influenced by EPA additives to perioperative nutritional supplements.

Citation Format: Kitti Jantharapattana, Orachat Orapipatpong. Efficacy of EPA-enriched supplement compared with standard formula on body weight changes in malnourished head and neck cancer patients undergoing surgery: A randomized study [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B02.