{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:30:18Z","timestamp":1782865818151,"version":"3.54.5"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,1,3]],"date-time":"2017-01-03T00:00:00Z","timestamp":1483401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011715","name":"Macmillan Cancer Support","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100011715","id-type":"DOI","asserted-by":"crossref"}]},{"name":"British Dietetics Association"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pre\u2010operative weight loss has been consistently associated with increased post\u2010operative morbidity. The study aims to determine if pre\u2010operative oral nutritional supplements (ONSs) with dietary advice reduce post\u2010operative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010blinded randomized controlled trial. People with colorectal cancer scheduled for surgery with pre\u2010operative weight loss &gt;1\u2009kg\/3\u20136\u2009months were randomized by using stratified blocks (1:1 ratio) in six hospitals (1 November 2013\u201328 February 2015). Intervention group was given 250\u2009mL\/day ONS (10.1\u2009KJ and 0.096\u2009g protein per mL) and dietary advice. Control group received dietary advice alone. Oral nutritional supplements were administered from diagnosis to the day preceding surgery. Research team was masked to group allocation. Primary outcome was patients with one or more surgical site infection (SSI) or chest infection; secondary outcomes included percentage weight loss, total complications, and body composition measurements. Intention\u2010to\u2010treat analysis was performed with both unadjusted and adjusted analyses. A sample size of 88 was required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 101 participants, (55 ONS, 46 controls) 97 had surgery. In intention\u2010to\u2010treat analysis, there were 21\/45 (47%) patients with an infection\u2014either an SSI or chest infection in the control group vs. 17\/55 (30%) in the ONS group. The odds ratio of a patient incurring either an SSI or chest infection was 0.532 (<jats:italic>P<\/jats:italic>\u2009=\u20090.135 confidence interval 0.232 to 1.218) in the unadjusted analysis and when adjusted for random differences at baseline (age, gender, percentage weight loss, and cancer staging) was 0.341 (<jats:italic>P<\/jats:italic>\u2009=\u20090.031, confidence interval 0.128 to 0.909). Pre\u2010operative percentage weight loss at the first time point after randomization was 4.1% [interquartile range (IQR) 1.7\u20137.0] in ONS group vs. 6.7% (IQR 2.6\u201310.8) in controls (Mann\u2013Whitney U <jats:italic>P<\/jats:italic>\u2009=\u20090.021) and post\u2010operatively was 7.4% (IQR 4.3\u201310.0) in ONS group vs. 10.2% (IQR 5.1\u201318.5) in controls (<jats:italic>P<\/jats:italic>\u2009=\u20090.016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with dietary advice alone, ONS resulted in patients having fewer infections and less weight loss following surgery for colorectal cancer. We have demonstrated that pre\u2010operative oral nutritional supplementation can improve clinical outcome in weight losing patients with colorectal cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12170","type":"journal-article","created":{"date-parts":[[2017,1,4]],"date-time":"2017-01-04T03:12:43Z","timestamp":1483499563000},"page":"437-446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":94,"title":["Pre\u2010operative oral nutritional supplementation with dietary advice versus dietary advice alone in weight\u2010losing patients with colorectal cancer: single\u2010blind randomized controlled trial"],"prefix":"10.1002","volume":"8","author":[{"given":"Sorrel T.","family":"Burden","sequence":"first","affiliation":[{"name":"School of Health Sciences The University of Manchester  Manchester UK"},{"name":"Salford Royal NHS Foundation Trust  Salford UK"},{"name":"Manchester Academic Health Sciences Centre (MAHSC)  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra J.","family":"Gibson","sequence":"additional","affiliation":[{"name":"School of Health Sciences The University of Manchester  Manchester UK"},{"name":"Manchester Academic Health Sciences Centre (MAHSC)  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lal","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust  Salford UK"},{"name":"School of Medicine The University of Manchester  Manchester UK"},{"name":"Manchester Academic Health Sciences Centre (MAHSC)  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Hill","sequence":"additional","affiliation":[{"name":"Central Manchester University Hospitals NHS Foundation Trust  Manchester UK"},{"name":"School of Medicine The University of Manchester  Manchester UK"},{"name":"Manchester Academic Health Sciences Centre (MAHSC)  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Pilling","sequence":"additional","affiliation":[{"name":"School of Health Sciences The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Soop","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust  Salford UK"},{"name":"School of Medicine The University of Manchester  Manchester UK"},{"name":"Manchester Academic Health Sciences Centre (MAHSC)  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aswatha","family":"Ramesh","sequence":"additional","affiliation":[{"name":"University Hospital South Manchester NHS Foundation Trust  Wythenshawe UK"},{"name":"Manchester Academic Health Sciences Centre (MAHSC)  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Todd","sequence":"additional","affiliation":[{"name":"School of Health Sciences The University of Manchester  Manchester UK"},{"name":"Manchester Academic Health Sciences Centre (MAHSC)  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,3]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"FerlayJ SI ErvikM DikshitR EserS MathersC RebeloM ParkinDM FormanD Bray F.GLOBOCAN 2012 v1.0 Cancer Incidence and Mortality Worldwide. 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