{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T08:33:39Z","timestamp":1793694819274,"version":"4.5.1"},"reference-count":38,"publisher":"Pacini Editore","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Otorhinolaryngol Ital"],"DOI":"10.14639\/0392-100x-n3140","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T04:08:28Z","timestamp":1747022908000},"page":"75-83","source":"Crossref","is-referenced-by-count":10,"title":["The impact of immunonutrition in head and neck cancer surgery: a systematic review with meta-analysis"],"prefix":"10.14639","volume":"45","author":[{"given":"Claudia Lodovica","family":"Modesti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Mattavelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Testa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Tofani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Piazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"20340","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"10.14639\/0392-100X-N3140_ref1","unstructured":"Casas-Rodera P, G\u00f3mez-Candela C, Ben\u00edtez S, et al. Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a prospective, randomized clinical trial. Nutr Hosp 2008;23:105-110. https:\/\/www.redalyc.org\/articulo.oa?id=309226725011"},{"key":"10.14639\/0392-100X-N3140_ref2","doi-asserted-by":"crossref","unstructured":"Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. https:\/\/doi.org\/10.3322\/caac.21492","DOI":"10.3322\/caac.21492"},{"key":"10.14639\/0392-100X-N3140_ref3","doi-asserted-by":"crossref","unstructured":"Alshadwi A, Nadershah M, Carlson ER, et al. Nutritional considerations for head and neck cancer patients: a review of the literature. J Oral Maxillofac Surg 2013;71:1853-1860. https:\/\/doi.org\/10.1016\/j.joms.2013.04.028","DOI":"10.1016\/j.joms.2013.04.028"},{"key":"10.14639\/0392-100X-N3140_ref4","doi-asserted-by":"crossref","unstructured":"Vander Poorten V, Uyttebroek S, Robbins KT, et al. Perioperative antibiotics in clean-contaminated head and neck surgery: a systematic review and meta-analysis. Adv Ther 2020;37:1360-1380. https:\/\/doi.org\/10.1007\/s12325-020-01269-2","DOI":"10.1007\/s12325-020-01269-2"},{"key":"10.14639\/0392-100X-N3140_ref5","doi-asserted-by":"crossref","unstructured":"Dedivitis RA, Aires FT, Cernea CR, et al. Pharyngocutaneous fistula after total laryngectomy: systematic review of risk factors. Head Neck 2015;37:1691-1697. https:\/\/doi.org\/10.1002\/hed.23804","DOI":"10.1002\/hed.23804"},{"key":"10.14639\/0392-100X-N3140_ref6","doi-asserted-by":"crossref","unstructured":"Wang M, Xun Y, Wang K, et al. Risk factors of pharyngocutaneous fistula after total laryngectomy: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2020;277:585-599. https:\/\/doi.org\/10.1007\/s00405-019-05718-9","DOI":"10.1007\/s00405-019-05718-9"},{"key":"10.14639\/0392-100X-N3140_ref7","doi-asserted-by":"crossref","unstructured":"Di Carlo V, Gianotti L, Balzano G, et al. Complications of pancreatic surgery and the role of perioperative nutrition. Dig Surg 1999;16:320-326. https:\/\/doi.org\/10.1159\/000018742","DOI":"10.1159\/000018742"},{"key":"10.14639\/0392-100X-N3140_ref8","doi-asserted-by":"crossref","unstructured":"Wu GH, Zhang YW, Wu ZH. Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients. World J Gastroenterol 2001;7:357-362. https:\/\/doi.org\/10.3748\/wjg.v7.i3.357","DOI":"10.3748\/wjg.v7.i3.357"},{"key":"10.14639\/0392-100X-N3140_ref9","doi-asserted-by":"crossref","unstructured":"Zhang Y, Gu Y, Guo T, et al. Perioperative immunonutrition for gastrointestinal cancer: a systematic review of randomized controlled trials. Surg Oncol 2012;21:E87-E95. https:\/\/doi.org\/10.1016\/j.suronc.2012.01.002","DOI":"10.1016\/j.suronc.2012.01.002"},{"key":"10.14639\/0392-100X-N3140_ref10","doi-asserted-by":"crossref","unstructured":"Heyland DK, Novak F, Drover JW, et al. Should immunonutrition become routine in critically ill patients? A systematic review of the evidence. JAMA 2001;286:944-953. https:\/\/doi.org\/10.1001\/jama.286.8.944","DOI":"10.1001\/jama.286.8.944"},{"key":"10.14639\/0392-100X-N3140_ref11","doi-asserted-by":"crossref","unstructured":"Howes N, Atkinson C, Thomas S, et al. Immunonutrition for patients undergoing surgery for head and neck cancer. Cochrane Database Syst Rev 2018;8:CD010954. https:\/\/doi.org\/10.1002\/14651858.CD010954.pub2.","DOI":"10.1002\/14651858.CD010954.pub2"},{"key":"10.14639\/0392-100X-N3140_ref12","doi-asserted-by":"crossref","unstructured":"Vidal-Casariego A, Calleja-Fern\u00e1ndez A, Villar-Taibo R, et al. Efficacy of arginine-enriched enteral formulas in the reduction of surgical complications in head and neck cancer: a systematic review and meta-analysis. Clin Nutr 2014;33:951-957. https:\/\/doi.org\/10.1016\/j.clnu.2014.04.020","DOI":"10.1016\/j.clnu.2014.04.020"},{"key":"10.14639\/0392-100X-N3140_ref13","doi-asserted-by":"crossref","unstructured":"Bertazzoni G, Testa G, Tomasoni M, et al. The Enhanced Recovery After Surgery (ERAS) protocol in head and neck cancer: a matched-pair analysis. Acta Otorhinolaryngol Ital 2022;42:325-333. https:\/\/doi.org\/10.14639\/0392-100X-N2072","DOI":"10.14639\/0392-100X-N2072"},{"key":"10.14639\/0392-100X-N3140_ref14","doi-asserted-by":"crossref","unstructured":"Coyle MJ, Main B, Hughes C, et al. Enhanced Recovery After Surgery (ERAS) for head and neck oncology patients. Clin Otolaryngol 2016;41:118-126. https:\/\/doi.org\/10.1111\/coa.12482","DOI":"10.1111\/coa.12482"},{"key":"10.14639\/0392-100X-N3140_ref15","doi-asserted-by":"crossref","unstructured":"Kiong KL, Vu CN, Yao C, et al. Enhanced Recovery After Surgery (ERAS) in head and neck oncologic surgery: a case-matched analysis of perioperative and pain outcomes. Ann Surg Oncol 2021;28:867-876. https:\/\/doi.org\/10.1245\/s10434-020-09174-2","DOI":"10.1245\/s10434-020-09174-2"},{"key":"10.14639\/0392-100X-N3140_ref16","doi-asserted-by":"crossref","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. https:\/\/doi.org\/10.1136\/bmj.n71","DOI":"10.1136\/bmj.n71"},{"key":"10.14639\/0392-100X-N3140_ref17","doi-asserted-by":"crossref","unstructured":"de Luis DA, Izaola O, Cuellar L, et al. Clinical and biochemical outcomes after a randomized trial with a high dose of enteral arginine formula in postsurgical head and neck cancer patients. Eur J Clin Nutr 2007;61:200-204. https:\/\/doi.org\/10.1038\/sj.ejcn.1602515","DOI":"10.1038\/sj.ejcn.1602515"},{"key":"10.14639\/0392-100X-N3140_ref18","unstructured":"de Luis D, Izaola O, de la Fuente B, et al. Effect of L-arginine supplementation on insulin resistance and adipocitokines levels in head and neck cancer non diabetic patients after surgery. Nutr Hosp 2014;30:870-875. https:\/\/doi.org\/10.3305\/nh.2014.30.4.7864"},{"key":"10.14639\/0392-100X-N3140_ref19","unstructured":"De Luis DA, Izaola O, Cuellar L, et al. High dose of arginine enhanced enteral nutrition in postsurgical head and neck cancer patients. A randomized clinical trial. Eur Rev Med Pharmacol Sci 2009;13:279-283."},{"key":"10.14639\/0392-100X-N3140_ref20","doi-asserted-by":"crossref","unstructured":"Snyderman CH, Kachman K, Molseed L, et al. Reduced postoperative infections with an immune-enhancing nutritional supplement. Laryngoscope 1999;109:915-921. https:\/\/doi.org\/10.1097\/00005537-199906000-00014","DOI":"10.1097\/00005537-199906000-00014"},{"key":"10.14639\/0392-100X-N3140_ref21","doi-asserted-by":"crossref","unstructured":"Sorensen D, McCarthy M, Baumgartner B, et al. Perioperative immunonutrition in head and neck cancer. Laryngoscope 2009;119:1358-1364. https:\/\/doi.org\/10.1002\/lary.20494","DOI":"10.1002\/lary.20494"},{"key":"10.14639\/0392-100X-N3140_ref22","doi-asserted-by":"crossref","unstructured":"Jantharapattana K, Orapipatpong O. Efficacy of EPA-enriched supplement compared with standard formula on body weight changes in malnourished patients with head and neck cancer undergone surgery: a randomized study. Head Neck 2020;42:188-197. https:\/\/doi.org\/10.1002\/hed.25987","DOI":"10.1002\/hed.25987"},{"key":"10.14639\/0392-100X-N3140_ref23","doi-asserted-by":"crossref","unstructured":"Sittitrai P, Ruenmarkkaew D, Booyaprapa S, et al. Effect of a perioperative immune-enhancing diet in clean-contaminated head and neck cancer surgery: a randomized controlled trial. Int J Surg 2021;93:106051. https:\/\/doi.org\/10.1016\/j.ijsu.2021.106051","DOI":"10.1016\/j.ijsu.2021.106051"},{"key":"10.14639\/0392-100X-N3140_ref24","doi-asserted-by":"crossref","unstructured":"Felekis D, Eleftheriadou A, Papadakos G, et al. Effect of perioperative immuno-enhanced enteral nutrition on inflammatory response, nutritional status, and outcomes in head and neck cancer patients undergoing major surgery. Nutr Cancer 2010;62:1105-1112. https:\/\/doi.org\/10.1080\/01635581.2010.494336","DOI":"10.1080\/01635581.2010.494336"},{"key":"10.14639\/0392-100X-N3140_ref25","doi-asserted-by":"crossref","unstructured":"Falewee MN, Schilf A, Boufflers E, et al. Reduced infections with perioperative immunonutrition in head and neck cancer: exploratory results of a multicenter, prospective, randomized, double-blind study. Clin Nutr 2014;33:776-784. https:\/\/doi.org\/10.1016\/j.clnu.2013.10.006","DOI":"10.1016\/j.clnu.2013.10.006"},{"key":"10.14639\/0392-100X-N3140_ref26","doi-asserted-by":"crossref","unstructured":"Riso S, Aluffi P, Brugnani M, et al. Postoperative enteral immunonutrition in head and neck cancer patients. Clin Nutr 2000;19:407-412. https:\/\/doi.org\/10.1054\/clnu.2000.0135","DOI":"10.1054\/clnu.2000.0135"},{"key":"10.14639\/0392-100X-N3140_ref27","doi-asserted-by":"crossref","unstructured":"Van Bokhorst-de Van der Schuer MA, Langendoen SI, Vondeling H, et al. Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomized clinical trial. Clin Nutr 2000;19:437-444. https:\/\/doi.org\/10.1054\/clnu.2000.0148","DOI":"10.1054\/clnu.2000.0148"},{"key":"10.14639\/0392-100X-N3140_ref28","doi-asserted-by":"crossref","unstructured":"Turnock A, Calder PC, West AL, et al. Perioperative immunonutrition in well-nourished patients undergoing surgery for head and neck cancer: evaluation of inflammatory and immunologic outcomes. Nutrients 2013;5:1186-1199. https:\/\/doi.org\/10.3390\/nu5041186","DOI":"10.3390\/nu5041186"},{"key":"10.14639\/0392-100X-N3140_ref29","doi-asserted-by":"crossref","unstructured":"Hanai N, Terada H, Hirakawa H, et al. Prospective randomized investigation implementing immunonutritional therapy using a nutritional supplement with a high blend ratio of-3 fatty acids during the perioperative period for head and neck carcinomas. Jpn J Clin Oncol 2018;48:356-361. https:\/\/doi.org\/10.1093\/jjco\/hyy008","DOI":"10.1093\/jjco\/hyy008"},{"key":"10.14639\/0392-100X-N3140_ref30","doi-asserted-by":"crossref","unstructured":"Ghosh S, Dempsey G, Skelly R, et al. A double blind, randomised, placebo controlled, feasibility phase III clinical trial of peri-operative immune-enhancing enteral nutrition in patients undergoing surgery for advanced head and neck cancer. e-SPEN Journal 2012;7:E107-E114. https:\/\/doi.org\/10.1016\/j.clnme.2011.12.001","DOI":"10.1016\/j.clnme.2011.12.001"},{"key":"10.14639\/0392-100X-N3140_ref31","doi-asserted-by":"crossref","unstructured":"de Luis DA, Izaola O, Cuellar L, et al. Effect of c-reactive protein and interleukins blood levels in postsurgery arginine-enhanced enteral nutrition in head and neck cancer patients. Eur J Clin Nutr 2003;57:96-99. https:\/\/doi.org\/10.1038\/sj.ejcn.1601512","DOI":"10.1038\/sj.ejcn.1601512"},{"key":"10.14639\/0392-100X-N3140_ref32","doi-asserted-by":"crossref","unstructured":"de Luis DA, Aller R, Izaola O, et al. Postsurgery enteral nutrition in head and neck cancer patients. Eur J Clin Nutr 2002;56:1126-1129. https:\/\/doi.org\/10.1038\/sj.ejcn.1601458","DOI":"10.1038\/sj.ejcn.1601458"},{"key":"10.14639\/0392-100X-N3140_ref33","doi-asserted-by":"crossref","unstructured":"Wilson AP, Treasure T, Sturridge MF, et al. A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis. Lancet 1986;1:311-313. https:\/\/doi.org\/10.1016\/s0140-6736(86)90838-x","DOI":"10.1016\/S0140-6736(86)90838-X"},{"key":"10.14639\/0392-100X-N3140_ref34","doi-asserted-by":"crossref","unstructured":"de Luis DA, Arranz M, Aller R, et al. Immunoenhanced enteral nutrition, effect on inflammatory markers in head and neck cancer patients. Eur J Clin Nutr 2005;59:145-147. https:\/\/doi.org\/10.1038\/sj.ejcn.1602034","DOI":"10.1038\/sj.ejcn.1602034"},{"key":"10.14639\/0392-100X-N3140_ref35","doi-asserted-by":"crossref","unstructured":"de Luis DA, Izaola O, Cuellar L, et al. Randomized clinical trial with an enteral arginine-enhanced formula in early postsurgical head and neck cancer patients. Eur J Clin Nutr 2004;58:1505-1508. https:\/\/doi.org\/10.1038\/sj.ejcn.1601999","DOI":"10.1038\/sj.ejcn.1601999"},{"key":"10.14639\/0392-100X-N3140_ref36","doi-asserted-by":"crossref","unstructured":"Kattar N, Wang SX, Trojan JD, et al. Enhanced recovery after surgery protocols for head and neck cancer: systematic review and meta-analysis. Otolaryngol Head Neck Surg 2023;168:593-601. https:\/\/doi.org\/10.1177\/01945998221082541","DOI":"10.1177\/01945998221082541"},{"key":"10.14639\/0392-100X-N3140_ref37","doi-asserted-by":"crossref","unstructured":"Grammatica A, Piazza C, Paderno A, et al. Free flaps in head and neck reconstruction after oncologic surgery: expected outcomes in the elderly. Otolaryngol Head Neck Surg 2015;152:796-802. https:\/\/doi.org\/10.1177\/0194599815576905","DOI":"10.1177\/0194599815576905"},{"key":"10.14639\/0392-100X-N3140_ref38","doi-asserted-by":"crossref","unstructured":"Matos LL, Sanabria A, Robbins KT, et al. Management of older patients with head and neck cancer: a comprehensive review. Adv Ther 2023;40:1957-1974. https:\/\/doi.org\/10.1007\/s12325-023-02460-x","DOI":"10.1007\/s12325-023-02460-x"}],"container-title":["Acta Otorhinolaryngologica Italica"],"original-title":[],"link":[{"URL":"https:\/\/www.actaitalica.it\/article\/view\/1301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T04:08:38Z","timestamp":1747022918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actaitalica.it\/article\/view\/1301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":38,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.14639\/0392-100x-n3140","relation":{},"ISSN":["1827-675X"],"issn-type":[{"value":"1827-675X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"article-number":"2"}}