Use of parenteral nutrition in patients with advanced cancer

Appl Physiol Nutr Metab. 2008 Feb;33(1):102-6. doi: 10.1139/H07-152.


The purpose of this study is to describe patient-related variables in a cohort of advanced cancer patients (ACPs) enrolled in a home parenteral nutrition (HPN) program. This study reviewed the cohort of ACPs enrolled in the Northern Alberta Home Total Parenteral Nutrition Program (NAHTPNP). Thirty-eight ACPs received HPN during the study period, 24% of all patients admitted for PN. Of these, 27 (71%) were female. Mean age was 48.76 y (SD 13.8 y). Bowel obstruction was the most common indication for initiating HPN (84%, 32) and ovarian cancer was the most common malignancy (34%, 13). Patients who began HPN with a Karnofsky performance status (KPS) of greater than 50 (median of 70) were found to have a longer duration of life (median: 6 months) compared with patients who began HPN with a KPS of 50 or below (median=50; median 3 months; p=0.01; two-tailed). There was no difference in survival between malignancy type (p=NS). Advanced cancer is the fastest growing indication for enrollment in the HPN program. ACP demonstrated a 3% average annual increase proportionate to all indications for HPN starts, accounting for 7%-48% of HPN starts from 1999-2006. HPN is an increasingly used therapy for patients with advanced cancer, most commonly for intestinal failure in the setting of bowel obstruction. Initiation of HPN at a higher KPS was associated with a longer duration of life. Further studies are needed to validate the use of TPN in end-stage cancer patients.

MeSH terms

  • Adult
  • Alberta
  • Cohort Studies
  • Female
  • Gastrointestinal Diseases / diet therapy
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / mortality
  • Humans
  • Male
  • Malnutrition / diet therapy*
  • Malnutrition / etiology*
  • Malnutrition / mortality
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / mortality
  • Palliative Care / methods*
  • Parenteral Nutrition, Home*
  • Retrospective Studies
  • Survival Analysis