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Unintentional weight loss is often a presenting symptom of upper gastrointestinal (UGI) cancer that progresses over the patients' treatment journey and is a prognostic indicator of morbidity and mortality. The aim of this study was to investigate the effect of early and intensive dietetic counselling on quality of life in people with UGI cancer compared with usual care; and compare two modes of intervention delivery: telephone vs. an asynchronous mobile application (App). Eligible participants were those newly diagnosed with UGI cancer. Participants were randomised to one of three groups: intervention via telephone, intervention via an App, or usual care. The intervention was additional to usual dietetic care and delivered by a dietitian using standardised behaviour change techniques, individually tailored to participants, initiated within 4 weeks of diagnosis and continued for 18 weeks. The primary outcome was quality-adjusted life years (QALY) determined using the EQ-5D-5L quality of life assessment tool and secondary outcomes included weight and survival, assessed at 3, 6, and 12 months. Data were analysed using linear mixed models. One hundred eleven participants were randomised. QALY and survival were not significantly different between groups over the 12-month follow up. Participants receiving the intervention via telephone lost less weight compared with those in the mobile App group (adjusted coefficient 2.56 kg (95% CI 4.89, 0.23), P = 0.031). The mobile App group had a greater number of withdrawals compared with the telephone group. Early and intensive dietetic counselling did not change QALY or survival for 12 months follow up compared with usual care. Nutrition counselling delivered via telephone, but not the mobile App, was effective for attenuating weight loss over the 12 months follow up.

Background: Low skeletal muscle mass (MM) is known to be associated with poor morbidity and mortality outcomes in cancer, but evidence of its impact on health related quality of life (HRQOL) is less established. This systematic review and meta-analysis examines the relationship between skeletal MM and HRQOL in adults with cancer. Methods : Five databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus, Scopus, PsycInfo) were systematically searched to identify studies reporting on the association between computed tomography (CT) derived skeletal MM, and a validated measure of HRQOL in adults with cancer. Studies classifying skeletal MM as a categorical variable (low or normal) were combined in a meta-analysis to investigate cross-sectional association with HRQOL. Studies reporting skeletal muscle as a continuous variable were qualitatively synthesised. Results : 14 studies involving 2,776 participants were eligible for inclusion. Participants were dichotomised according to low or normal skeletal MM in ten studies (n = 1,375); 58% had low MM. Low MM was associated with poorer global HRQOL scores (n = 985 from seven studies, standardised mean difference -0.27, 95% CI -0.40 to -0.14, P < 0.0001), and poorer physical functioning domain HRQOL scores (n = 507 from five studies, standardised mean difference -0.40, 95% CI -0.74 to -0.05, P = 0.02), but not social, role, emotional or cognitive functioning domain scores. Five studies examined the cross-sectional relationship between HRQOL and skeletal muscle mass as a continuous variable, and found little evidence of an association unless non-linear analysis was used. Two studies investigated the relationship between longitudinal changes in both skeletal muscle and HRQOL, reporting that an association exists across several HRQOL domains.

Background: Postoperative nutrition support is an essential component of management in upper gastrointestinal (UGI) cancer resection, however there is limited knowledge of current clinical practice. This study aimed to describe the postoperative nutrition support received by patients undergoing UGI cancer resections, assess adherence with ESPEN surgical guideline recommendations, and to investigate differences between oesophageal, gastric and pancreatic surgeries. The secondary aim was to explore the association of adherence with ESPEN guidelines and provision of nutrition support, with surgical complications and length of stay (LOS). Method(s): The NOURISH point prevalence study was conducted between September 2019-June 2020 across 27 Australian tertiary centres. Malnutrition was diagnosed using subjective global assessment. Data on postoperative diet codes, prescription of nutrition support (oral (ONS), enteral (EN), parenteral (PN)) and nutritional adequacy were collected by dietitians for the first 10 days of admission. Fisher's exact test was used to determine differences in nutritional management and adherence to ESPEN guidelines between surgery types. Multivariate regression analysed associations with surgical outcomes. Result(s): Two-hundred participants were included (42% pancreatic, 33% oesophageal, 25% gastric surgery). Overall, only 34.9% (n = 53) met the guideline recommendations that were applicable to them. Early oral intake of fluids or solids (within 24 h post surgery) was initiated for 23.5% (n = 47), whilst ONS/EN/PN was initiated for 49.5% (n = 99). Only 25% of pancreatic surgeries had nutrition support initiated on the first postoperative day compared to 86.4% of oesophageal and 42.0% of gastric surgeries (p < 0.001). In those who were 'nil by mouth', EN/PN were commenced within 24 h for 51.0% (n = 78), with 18.5% and 45.2% for pancreatic and gastric surgeries compared to 86.0% in oesophageal surgeries (p < 0.001). In malnourished patients, 35.7

BACKGROUND: Delay in dietetic service provision for upper gastrointestinal cancer exacerbates disease-related malnutrition and consequently increases morbidity and mortality. Dietetic services are usually referral-based and provided face-to-face in inpatient or outpatient settings, which can delay the commencement of nutrition care. The aim of this study was to provide intensive dietetic intervention close to the time of diagnosis for upper gastrointestinal cancer and assess the effect on quality-adjusted life years. METHODS: A three-arm randomised controlled trial of adults newly diagnosed with upper gastrointestinal cancer was performed. A behavioural-based, individually tailored, symptom-directed nutrition intervention was provided in addition to usual care, delivered by a dietitian using a telephone (synchronously) or a mobile application (asynchronously) for 18 weeks, compared with a usual care control group. Data were collected at baseline, three, six, and twelve months post-randomisation. The primary outcome was quality-adjusted life years (EQ-5D-5L quality of life assessment tool). Data were analysed using linear mixed models. RESULTS: One hundred and eleven participants were randomised. Quality-adjusted life years were not different in the intervention groups compared with control (telephone: mean (95% CI) 0.04 (0.43, 2.3), p = 0.998; App: -0.08 (-0.18, 0.02), p = 0.135) after adjustment for baseline, nutrition risk status, age, and gender. Survival was similar between groups over 12 months. The asynchronous mobile app group had a greater number of withdrawals compared with the telephone group. CONCLUSION: Early and intensive nutrition counselling, delivered at home, during anticancer treatment did not change quality-adjusted life years or survival over 12 months compared with usual care. Behavioural counselling alone was unable to achieve nutritional adequacy. Dietetic services delivered asynchronously using a mobile app had low acceptance for patients und

Background:Malnutrition in patients with upper gastrointestinal cancer confers greater risks of morbidity and mortality. Novel costeffective approaches that can deliver early, pre-hospital nutrition intervention before usual hospital dietetic service is commenced are needed. Linking clinicians and patients via mobile health and wireless technologies is a contemporary solution not yet tested for delivery of nutrition therapy to people with cancer. The aim of this study is to commence nutrition intervention earlier than usual care and evaluate the effects of using the telephone or mHealth for intervention delivery. It is hypothesised that participants allocated to receive the early and intensive pre-hospital dietetic service will have more quality of life compared with control participants. This study will also demonstrate the feasibility and effectiveness of eHealth for the nutrition management of patients at home undergoing cancer treatment. Method(s): This study is a prospective three-group randomised controlled trial, with a concurrent economic evaluation. The 18-week intervention is provided in addition to usual care and is delivered by two different modes, via telephone (group 1) or via mHealth (group 2). The control group receives usual care alone (group 3). The intervention is an individually tailored, symptom-directed nutritional behavioural management program led by a dietitian. Participants will have at least fortnightly reviews. The primary outcome is quality-adjusted life years lived and secondary outcomes include markers of nutritional status. Outcomes will be measured at 3, 6 and 12months follow-up. Discussion(s): The findings will provide evidence of a strategy to implement early and intensive nutrition intervention outside the hospital setting that can favourably impact on quality of life and nutritional status. This patient-centred approach is relevant to current health service provision and challenges the current reactive delivery model of care.

Aims: Background: Upper gastrointestinal (UGI) cancers (pancreatic, oesophageal and stomach) have a dismal prognosis, with five-year survival of only 7.7-28.5% even when detected in their early stages and treated with a complete resection. UGI cancers are characterised by a high symptom burden. It is critical that patients with these cancers receive the best possible symptomatic control, while the search continues for treatments to improve survival. Recent research has shown that patient-reported outcomes (PROs), integrated into clinical practice in a meaningful way to drive action, are associated with improved patient health outcomes and decrease burden to the healthcare system. Aim(s): To determine whether the systematic measurement, identification and management of PROs in clinical practice, coupled with information support to patients, improves health outcomes for patients with UGI cancers. Methods and Design: A registry-based randomised, multicentre, controlled trial will be designed to assess whether, compared to usual practice, the UGI Cancer Care Coordination (UGICCC) intervention is effective in improving health-related quality of life in patients diagnosed with UGI cancers, as the primary outcome. The UGICCC intervention involves: (1) collection of PROs to allow patients to track and report their symptoms over time; (2) provision of real-time feedback to patients for management of symptoms; and (3) alerts to a care-coordinator of patients reporting severe or worsening symptoms to allow for triage and follow-up as well as provision of real-time reports to clinicians. The secondary outcome measures are to assess whether patients assigned to the intervention arm demonstrate: reduced health service use and emergency department visits; lower level of information needs; timely referral to palliative care services; and increased median survival. These will be evaluated at baseline, 3-, 6- and 12-months. Participants will be recruited from eight hospitals in Victo

Background: Postoperative nutrition support is an essential component of management in upper gastrointestinal (UGI) cancer resection, however there is limited knowledge of current clinical practice. This study aimed to describe the postoperative nutrition support received by patients undergoing UGI cancer resections, assess adherence with ESPEN surgical guideline recommendations, and to investigate differences between oesophageal, gastric and pancreatic surgeries. The secondary aim was to explore the association of adherence with ESPEN guidelines and provision of nutrition support, with surgical complications and length of stay (LOS). Method(s): The NOURISH point prevalence study was conducted between September 2019-June 2020 across 27 Australian tertiary centres. Malnutrition was diagnosed using subjective global assessment. Data on postoperative diet codes, prescription of nutrition support (oral (ONS), enteral (EN), parenteral (PN)) and nutritional adequacy were collected by dietitians for the first 10 days of admission. Fisher's exact test was used to determine differences in nutritional management and adherence to ESPEN guidelines between surgery types. Multivariate regression analysed associations with surgical outcomes. Result(s): Two-hundred participants were included (42% pancreatic, 33% oesophageal, 25% gastric surgery). Overall, only 34.9% (n = 53) met the guideline recommendations that were applicable to them. Early oral intake of fluids or solids (within 24 h post surgery) was initiated for 23.5% (n = 47), whilst ONS/EN/PN was initiated for 49.5% (n = 99). Only 25% of pancreatic surgeries had nutrition support initiated on the first postoperative day compared to 86.4% of oesophageal and 42.0% of gastric surgeries (p < 0.001). In those who were 'nil by mouth', EN/PN were commenced within 24 h for 51.0% (n = 78), with 18.5% and 45.2% for pancreatic and gastric surgeries compared to 86.0% in oesophageal surgeries (p < 0.001). In malnourished patients, 35.7

Introduction: Upper gastrointestinal cancers are a significant health problem, with low survival, high symptom burden and unmet supportive care needs. Evidence-based clinical care pathways to standardise symptommanagement could provide a means to reduce symptom burden and improve quality of life in these patients. Method(s): A standardised model for clinical pathway development was used, this included: 1) assembling a team of experts; 2) compiling and reviewing existing literature; and 3) developing the pathway via a consensus working group process. A Clinical Working Group (CWG) was convened and included representatives of relevant specialities with established expertise and clinical experience from across ten public, private, metropolitan and regional health services inVictoria, Australia. Literature reviews were conducted to identify existing clinical symptom management and triage pathways or guidelines for patients with cancer as well as to identify any validated disease-specific patientreported outcome measures in order to ascertain potential symptoms. The initial pathways were drafted by cancer nurse consultants with over 10-years clinical experience in consultation with a 'clinical champion'. The CWGheld workshops to discuss and review each of the draft pathways. The pathways were updated and circulated to the whole CWGvia email for final approval. Result(s): A total of 64 disease-specific symptoms were identified. The CWG finalised and approved 19 clinical pathways to manage these symptoms. Each clinical pathway includes an informed tailored clinical assessment of the symptom based on the NOPQRSTUV Symptom Assessment Acronym, triage of the symptom using the Common Terminology Criteria for Adverse Events (Version 5.0) and interventions for appropriate follow-up care. Conclusion(s): A multidisciplinary approach and clinical consensus informed the development of evidence-based clinical pathways, which provide a standardised platform to appropriately manage and

Background: People with upper gastrointestinal cancer are at high risk for malnutrition without universal access to early nutrition interventions. Very little data exist on the attitudes and views of health professionals on providing nutrition care to this patient cohort delivered by electronic health methods. COVID-19 has fast-tracked the adoption of digital health care provision, so it is more important than ever to understand the needs of health professionals in providing health care via these modes. This study aimed to explore the perspectives of health professionals on providing nutrition care to upper gastrointestinal cancer patients by electronic methods to allow the future scaling-up of acceptable delivery methods. Method(s): Semi-structured qualitative interviews were conducted face-to-face or by telephone and recorded, de-identified and transcribed. Thematic analysis was facilitated by NVivo Pro 12. Result(s): Interviews were conducted on 13 health professionals from a range of disciplines across several public and private health institutions. Thematic analysis revealed three main themes: (1) the ideal model, (2) barriers to the ideal model and (3) how to implement and translate the ideal model. Health professionals viewed the provision of nutrition interventions as an essential part of an upper gastrointestinal cancer patient's treatment with synchronous, telephone-based internal health service models of nutrition care overwhelmingly seen as the most acceptable model of delivery. Mobile application-based delivery methods were deemed too challenging for the current population serviced by these clinicians. Conclusion(s): The use of novel technology for delivering nutrition care to people receiving treatment for upper gastrointestinal cancers was not widely accepted as the preferred method of delivery by health professionals. There is an opportunity, given the rapid uptake of digital health care delivery, to ensure that the views and attitudes of health prof

Background Adults diagnosed with cancers of the stomach, esophagus, and pancreas are at high risk of malnutrition. In many hospital-based health care settings, there is a lack of systems in place to provide the early and intensive nutritional support that is required by these high-risk cancer patients. Our research team conducted a 3-arm parallel randomized controlled trial to test the provision of an early and intensive nutrition intervention to patients with upper gastrointestinal cancers using a synchronous telephone-based delivery approach versus an asynchronous mobile app–based approach delivered using an iPad compared with a control group to address this issue. Objective This study aims to explore the overall acceptability of an early and intensive eHealth nutrition intervention delivered either via a synchronous telephone-based approach or an asynchronous mobile app–based approach. Methods Patients who were newly diagnosed with upper gastrointestinal cancer and who consented to participate in a nutrition intervention were recruited. In-depth, semistructured qualitative interviews were conducted by telephone and transcribed verbatim. Data were analyzed using deductive thematic analysis using the Theoretical Framework of Acceptability in NVivo Pro 12 Plus. Results A total of 20 participants were interviewed, 10 from each intervention group (synchronous or asynchronous delivery). Four major themes emerged from the qualitative synthesis: participants’ self-efficacy, low levels of burden, and intervention comprehension were required for intervention effectiveness and positive affect; participants sought a sense of support and security through relationship building and rapport with their dietitian; knowledge acquisition and learni

Background: People with upper gastrointestinal cancer are at high risk for malnutrition without universal access to early nutrition interventions. Very little data exist on the attitudes and views of health professionals on providing nutrition care to this patient cohort delivered by electronic health methods. COVID-19 has fast-tracked the adoption of digital health care provision, so it is more important than ever to understand the needs of health professionals in providing health care via these modes. This study aimed to explore the perspectives of health professionals on providing nutrition care to upper gastrointestinal cancer patients by electronic methods to allow the future scaling-up of acceptable delivery methods. Methods: Semi-structured qualitative interviews were conducted face-to-face or by telephone and recorded, de-identified and transcribed. Thematic analysis was facilitated by NVivo Pro 12. Results: Interviews were conducted on 13 health professionals from a range of disciplines across several public and private health institutions. Thematic analysis revealed three main themes: (1) the ideal model, (2) barriers to the ideal model and (3) how to implement and translate the ideal model. Health professionals viewed the provision of nutrition interventions as an essential part of an upper gastrointestinal cancer patient’s treatment with synchronous, telephone-based internal health service models of nutrition care overwhelmingly seen as the most acceptable model of delivery. Mobile application-based delivery methods were deemed too challenging for the current population serviced by these clinicians. Conclusion: The use of novel technology for delivering nutrition care to people receiving treatment for upper gastrointestinal cancers was not widely accepted as the preferred method of delivery by health professionals. There is an opportunity, given the rapid uptake of digital health care delivery, to ensure that the views and attitudes of health profe

Rationale: Increased accessibility to the mobile internet has seen a rapid expansion in e-health behaviour change interventions delivered to cancer survivors using synchronous and asynchronous delivery Methods. There is a need to characterise effective delivery Methods of e-health health interventions to enable improved design and implementation of evidence-based health behaviour change interventions. Method(s): We systematically reviewed and synthesised the evidence on the success of e-health behaviour change interventions in cancer survivors delivered by synchronous or asynchronous Methods compared to a control group. Engagement with the intervention, behaviour change and health outcomes were examined. A search of SCOPUS, Ovid MEDLINE, EMBASE, CINAHL Plus, PsycINFO, Cochrane CENTRAL and PubMed was conducted for studies published 2007 to March 2019. We looked for randomised controlled trials (RCTs) examining interventions delivered to adult cancer survivors via e-health Methods with a measure of health behaviour change taken at the end of the intervention. Random effects meta-analysis was performed examining whether the method of e-health delivery impacted the level of engagement, behaviour change and health outcomes. Result(s): Twenty-four RCTs were included, predominantly examining dietary and physical activity behaviour change interventions. Participant initiation of use of e-health interventions was high (88%). Use of e-health interventions improved: [Formula presented] Mode of delivery did not influence the amount of dietary and physical activity behaviour change observed. Conclusion(s): Physical activity and dietary behaviour change e-health interventions delivered to survivors of cancer have a small to moderate impact on behaviour change and small benefit to quality of life, fatigue, depression and anxiety. There is insufficient evidence to determine if asynchronous or synchronous delivery modes yield superior results. Disclosure of Interest: None declaredCo

Background: Increased accessibility to the internet and mobile devices has seen a rapid expansion in electronic health (eHealth) behavior change interventions delivered to patients with cancer and survivors using synchronous, asynchronous, and combined delivery methods. Characterizing effective delivery methods of eHealth interventions is required to enable improved design and implementation of evidence-based health behavior change interventions. Objective(s): This study aims to systematically review the literature and synthesize evidence on the success of eHealth behavior change interventions in patients with cancer and survivors delivered by synchronous, asynchronous, or combined methods compared with a control group. Engagement with the intervention, behavior change, and health outcomes, including quality of life, fatigue, depression, and anxiety, were examined. Method(s): A search of Scopus, Ovid MEDLINE, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature Plus, PsycINFO, Cochrane CENTRAL, and PubMed was conducted for studies published between March 2007 and March 2019. We looked for randomized controlled trials (RCTs) examining interventions delivered to adult cancer survivors via eHealth methods with a measure of health behavior change. Random-effects meta-analysis was performed to examine whether the method of eHealth delivery impacted the level of engagement, behavior change, and health outcomes. Result(s): A total of 24 RCTs were included predominantly examining dietary and physical activity behavior change interventions. There were 11 studies that used a synchronous approach and 11 studies that used an asynchronous approach, whereas 2 studies used a combined delivery method. Use of eHealth interventions improved exercise behavior (standardized mean difference [SMD] 0.34, 95% CI 0.21-0.48), diet behavior (SMD 0.44, 95% CI 0.18-0.70), fatigue (SMD 0.21, 95% CI -0.08 to 0.50; SMD change 0.22, 95% CI 0.09-0.35), anxiety (SMD 1.21

Background: A major challenge for those living with cancers of the upper gastrointestinal tract (oesophagus, stomach and pancreas), is the impact of the disease and treatment on nutritional status and quality of life. People with cancer and malnutrition have a greater risk of morbidity and mortality. Nutrition intervention is recommended to commence immediately in those who are malnourished or at risk of malnutrition. Novel cost-effective approaches that can deliver early, pre-hospital nutrition intervention before usual hospital dietetic service is commenced are needed. Linking clinicians and patients via mobile health (mHealth) and wireless technologies is a contemporary solution not yet tested for delivery of nutrition therapy to people with cancer. The aim of this study is to commence nutrition intervention earlier than usual care and evaluate the effects of using the telephone or mHealth for intervention delivery. It is hypothesised that participants allocated to receive the early and intensive pre-hospital dietetic service will have more quality-adjusted life years lived compared with control participants. This study will also demonstrate the feasibility and effectiveness of mHealth for the nutrition management of patients at home undergoing cancer treatment. Method(s): This study is a prospective three-group randomised controlled trial, with a concurrent economic evaluation. The 18 week intervention is provided in addition to usual care and is delivered by two different modes, via telephone (group 1) or via mHealth (group 2), The control group receives usual care alone (group 3). The intervention is an individually tailored, symptom-directed nutritional behavioural management program led by a dietitian. Participants will have at least fortnightly reviews. The primary outcome is quality adjusted life years lived and secondary outcomes include markers of nutritional status. Outcomes will be measured at three, six and 12 months follow up. Discussion(s): The find

Background: Cancers of the upper gastrointestinal tract commonly result in malnutrition, which increases morbidity and mortality. Current nutrition best practice lacks a mechanism to provide early and intensive nutrition support to these patients. A 3-arm parallel randomised controlled trial is testing the provision of a tailored, nutritional counselling intervention delivered using a synchronous, telephone-based approach or an asynchronous, mobile application-based approach to address this problem. This protocol outlines the design and methods that will be used to undertake an evaluation of the implementation process, which is imperative for successful replication and dissemination. Method(s): A concurrent triangulation mixed methods comparative analysis will be undertaken. The nutrition intervention will be provided using best practice behaviour change techniques and communicated either via telephone or via mHealth. The implementation outcomes that will be measured are: fidelity to the nutrition intervention protocol and to the delivery approach; engagement; acceptability and contextual factors. Qualitative data from recorded telephone consultations and written messages will be analysed through a coding matrix against the behaviour change techniques outlined in the standard operating procedure, and also thematically to determine barriers and enablers. Negative binomial regression will be used to test for predictive relationships between intervention components with health-related quality of life and nutrition outcomes. Post-intervention interviews with participants and health professionals will be thematically analysed to determine the acceptability of delivery approaches. NVivo 11 Pro software will be used to code for thematic analysis. STATA version 15 will be used to perform quantitative analysis. Discussion(s): The findings of this process evaluation will provide evidence of the core active ingredients that enable the implementation of best practice nutrition

BACKGROUND: Cancers of the upper gastrointestinal tract commonly result in malnutrition, which increases morbidity and mortality. Current nutrition best practice lacks a mechanism to provide early and intensive nutrition support to these patients. A 3-arm parallel randomised controlled trial is testing the provision of a tailored, nutritional counselling intervention delivered using a synchronous, telephone-based approach or an asynchronous, mobile application-based approach to address this problem. This protocol outlines the design and methods that will be used to undertake an evaluation of the implementation process, which is imperative for successful replication and dissemination. METHODS: A concurrent triangulation mixed methods comparative analysis will be undertaken. The nutrition intervention will be provided using best practice behaviour change techniques and communicated either via telephone or via mHealth. The implementation outcomes that will be measured are: fidelity to the nutrition intervention protocol and to the delivery approach; engagement; acceptability and contextual factors. Qualitative data from recorded telephone consultations and written messages will be analysed through a coding matrix against the behaviour change techniques outlined in the standard operating procedure, and also thematically to determine barriers and enablers. Negative binomial regression will be used to test for predictive relationships between intervention components with health-related quality of life and nutrition outcomes. Post-intervention interviews with participants and health professionals will be thematically analysed to determine the acceptability of delivery approaches. NVivo 11 Pro software will be used to code for thematic analysis. STATA version 15 will be used to perform quantitative analysis. DISCUSSION: The findings of this process evaluation will provide evidence of the core active ingredients that enable the implementation of best practice nutrition inter

Purpose: This study aimed to evaluate the long-term survival of all patients who participated in a pilot randomised trial of an early nutritional intervention for adults with upper gastrointestinal cancer. It also sought to identify factors that predicted patient mortality. Method(s): All participants (n = 21) who were randomised into the original study were followed for a maximum of 5 years and 2 months (final follow-up April 2016). The primary outcome measure was time from date of recruitment until date of death, ascertained by the Victorian Cancer Registry and/or Monash Health Scanned Medical Records. Secondary analyses were conducted to identify factors that adversely affected survival. Result(s): At the end of the follow-up period, three patients were alive in the nutrition intervention group whilst only two patients were living from the standard care group. Visual evaluation of the Kaplan-Meier survival curves demonstrated a possible survival benefit from being exposed to the intervention between 6 months and 1.4 years post-recruitment, though this benefit dissipated soon after. The intervention was not associated with increased survival in univariate analyses, but was after adjustment for other factors found to adversely impact on survival (adjusted hazard ratio 0.12 (95% CI 0.02-0.72) p = 0.02). These factors were being a smoker (14.2 (1.43 to 140.67), p = 0.02); low baseline physical functioning (1.11 (1.01 to 1.21), p = 0.03); high baseline fatigue (1.09 (1.02-1.16), p = 0.007); and high baseline dyspnoea (1.08 (1.02-1.13), p = 0.003). Conclusion(s): Early and intensive nutrition intervention may increase the survival of people with upper gastrointestinal cancer.Copyright © 2017, Springer-Verlag GmbH Germany.