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This study aimed to investigate the effectiveness of preoperative and an extended 90-days postoperative use of ONS among patients undergoing elective surgery for breast and colorectal cancers. Ninety-one patients were randomised into (i) Group SS received ONS up to 14 days preoperatively and postoperatively up to discharge, (ii) Group SS-E received ONS up to 14 days preoperatively, postoperatively up to discharge and for an extended 90-days after discharge and (iii) Group DS received ONS postoperatively up to discharge. Preoperatively, SS had significantly higher body weight (66.1 ± 15.3 kg vs. 62.5 ± 12.0 kg, p = 0.010) and BMI (26.8 ± 6.8 kg/m2 vs. 26.1 ± 6.7 kg/m2, p = 0.022) than DS when adjusted for baseline values. Postoperatively, SS-E had significantly higher handgrip strength (26 ± 9 kgF vs. 24 ± 6 kgF, p = 0.044) than DS at 90-days post-discharge after adjusted for preoperative values. At 90-days post-discharge, the proportions of patients in SS with albumin < 35 g/d, CAR ≥ 0.1, mPINI ≥ 0.4, mGPS score 1 or 2 were significantly reduced while in SS-E, the reduction in proportions of patients with high hsCRP and mPINI ≥ 0.4 was significant compared to upon discharge. Preoperative ONS had modest benefits in attenuating weight loss whilst postoperative supplementation up to 90-days post-discharge improved handgrip strength and inflammatory prognostic markers.

Background: Malnutrition is common among cancer patients, and it can impact the surgical outcomes of the patients undergoing elective surgery. Addressing malnutrition at the early stage of treatment will enhance the recovery process of the patients after anti-cancer treatments. Our study aimed to assess the nutritional status among breast and colorectal cancer patients who were scheduled for elective surgery and treatment. Methods: A total of 89 patients, 46 breast cancer patients and 43 colorectal cancer patients participated in the study. Sociodemographic information and medical history were collected using a questionnaire. Body weight and height were measured using a weighing scale and stadiometer. Body composition data were collected using an 8-point bioimpedance analysis machine. Dietary intake was collected using a 7-day diet history. Handgrip strength was evaluated using a dynamometer. The prevalence of malnutrition was determined based on the AND/ASPEN malnutrition clinical characteristics. The differences between groups were analysed using independent sample t-test, Mann Whitney U test and chi-square test. Results: Out of 89 patients, 51.7% were diagnosed as being malnourished based on the AND/ASPEN characteristics. The most common malnutrition characteristic observed among the breast and colorectal cancer patients was reduced handgrip strength (56.2%), followed by experience of muscle loss (43.8%) and reduced food intake (42.7%). Conclusion: There was a high prevalence of patients at risk of malnutrition among breast and colon cancer patients undergoing surgery. Early detection of malnutrition in cancer patients allows healthcare professionals to provide prompt intervention and improve their prognosis. [ABSTRACT FROM AUTHOR]

Background: The American Thyroid Association (ATA) has recently revised its guidance pertaining to thyroid nodules and follicular cell-derived thyroid cancer. The 2015 guidelines are massive in both scope and scale, with changes in the organizational approach to risk stratification of nodules and cancer, as well as multiple sections covering new material. This review highlights the major structural and organizational changes, focusing attention on the most dramatically changed recommendations, that is, those recommendations that clinicians will find striking because they call for significant divergence from prior clinical practice. Summary: The revised approach to thyroid nodule risk stratification is based on sonographic pattern, with an emphasis on pattern rather than growth in the long-term surveillance of nodules. Accumulating data have also been incorporated into an updated risk stratification scheme for thyroid cancer that increases the size of the low-risk pool, in part because low-volume lymph nodal metastases are now considered low risk. The most fundamentally altered recommendation is that lobectomy might be considered as the initial surgical approach for follicular cell-derived thyroid cancers from 1 to 4 cm in size. Conclusions: The underlying theme of the 2015 ATA guidelines is that ''less is more.'' As these new recommendations are adopted, fewer fine-needle aspiration biopsies will need to be done, less extensive surgeries will become more common, less radioactive iodine will be used either for treatment or for diagnostics, and less stimulated thyroglobulin testing will be done. Mastery of these guidelines will help clinicians know when it is reasonable to do less, thus providing responsibly individualized therapy for their patients. [ABSTRACT FROM AUTHOR]