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Home parenteral nutrition in neuroendocrine tumour intestinal failure: improved quality of life and longevity
  1. Vandana M Sagar1,
  2. Tahir Shah1,
  3. Hardip Malhi2,
  4. Sharmalie Parkinson2,
  5. Shishir Shetty1 and
  6. Sheldon C Cooper2
  1. 1Department of Hepatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Sheldon C Cooper, Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK; sheldon.cooper{at}uhb.nhs.uk

Abstract

Background Neuroendocrine tumours (NETs) are neoplastic yet behave differently to typical cancers. Despite often being slow growing, they can lead to significant gastrointestinal complications including intestinal failure (IF). The use of home parenteral nutrition (HPN) in neoplastic conditions is rising, primarily for palliation and bridging through treatments for cancer, but remains a challenging decision with a paucity of high-grade evidence-based guidance.

Methods A retrospective analysis of patients with NET on HPN was performed. Data collected included the cause of IF, complications encountered with HPN and changes in nutritional assessments.

Results Eight patients were identified, all with metastatic NET. Median weight improved following HPN commencement and line sepsis was the sole complication. All patients had stabilisation and optimisation of nutritional and hydration status.

Conclusions HPN is commenced to improve or maintain patients’ nutritional status during often lifelong treatment. The principle aim in providing HPN was to improve survival and quality of life. While NETs are cancers, our case series demonstrates the potential of HPN to actively support longer term survival in the subgroup of patients who develop IF.

  • intestinal obstruction
  • cachexia
  • quality of life
  • prognosis
  • home care
  • clinical decisions
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Footnotes

  • Contributors VMS, TS and SCC contributed to the design of the manuscript. VMS, TS, SS and SCC wrote the manuscript. VMS, HM, SP and SCC interpreted and analysed the data. All authors critically revised the manuscript and approved the final version of the manuscript.

  • Funding Novartis provided a grant to part fund a research fellow (VMS).

  • Competing interests VMS has received personal fees from Ipsen, and Novartis provided a grant to part fund her research fellow position. SCC has received educational sponsorship from Takeda and Fresenius-Kabi/Calea and honoraria from Novartis. TS has received grants from Ipsen and personal fees from AAA. SS has received personal fees from Faron Pharmaceuticals. Other authors have no conflicting interests to declare.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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