Colorectal cancer is the fourth most common cancer in men and the third most common cancer in women worldwide[1]. It is also a significant cause of morbidity and mortality throughout the world[2]. Malnutrition is common in patients presenting for surgical management of colorectal cancer, and multiple factors, such as tumor location, tumor type, tumor stage, and preoperative radiation or chemotherapy, may predispose the patients to malnutrition[3]. Postoperative outcomes, including incidence of complications, morbidity and survival, are usually better in the patients who are in a good nutritional condition[4]. Comprehensive clinical application of nutrition support in colorectal cancer patients appears to be necessary.
Unfortunately, malnutrition has remained a troublesome problem because of lack of nutrition support routines and a discrepancy between clinical practice and guidelines regarding nutrition support [5].
Currently, international guidelines on nutrition support have been established, such as the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines and the American Society for Parenteral and Enteral Nutrition (ASPEN) guidelines. Both are the authoritative guidelines at present, and should be followed and used in clinical practice as appropriate to the specific medical condition. However, since fewer than one sixth of the recommendations in the current guidelines are Grade A, and more than 50% are Grade C[6], more and better controlled trials are needed in the specific fields.
We carried out a retrospective study to evaluate the nutritional risk of colorectal cancer patients who underwent elective surgery, and assessed the nutrition support process by analyzing the postoperative clinical outcomes and comparing with the international recommendations or guidelines. In particular, we investigated the current status of nutrition support for patients undergoing surgery for colorectal cancer, and determined the requirements of feasible and appropriate nutrition support strategies for such patients.