Associations between omega-3 polyunsaturated fatty acids supplementation and surgical prognosis in patients with gastrointestinal cancer: A systematic review and meta-analysis

Shuai Lu; Zhenpeng Yang; Huazhen Tang; Xibo Sun; Bing Wang; Jinxiu Qu; Yuying Wang; Penghui Yang; Benqiang Rao

doi:10.1016/j.fochms.2022.100099

Associations between omega-3 polyunsaturated fatty acids supplementation and surgical prognosis in patients with gastrointestinal cancer: A systematic review and meta-analysis

Food Chem (Oxf). 2022 Mar 12:4:100099. doi: 10.1016/j.fochms.2022.100099. eCollection 2022 Jul 30.

Authors

Shuai Lu^{1

2}, Zhenpeng Yang^{1

2}, Huazhen Tang^{1

2}, Xibo Sun³, Bing Wang^{1

2}, Jinxiu Qu^{1

2}, Yuying Wang^{1

2}, Penghui Yang⁴, Benqiang Rao^{1

2}

Affiliations

¹ Department of General Surgery, Beijing Shijitan Hospital Affiliated Capital Medical University, Beijing 100038, China.
² Key Laboratory of Cancer Foods for Special Medical Purpose (FSMP) for State Market Regulation, Beijing 100038, China.
³ Department of Breast Surgery, The Second Affiliated Hospital of Shandong First Medical University, Shandong 271000, China.
⁴ The Fifth Medical Center of PLA General Hospital, Beijing 100039, China.

Abstract

Background: Surgical resection remains the primary treatment for gastrointestinal (GI) cancer, omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been reported to improve the prognosis of patients undergoing gastrointestinal tumor surgery. This meta-analysis aims to explore the efficacy of n-3 PUFAs on GI cancer patients undergoing surgery.

Methods: A systematic search of PubMed, Cochrane Library databases, EMBASE (until December 2021) was conducted. PRISMA checklist was followed. The data were analyzed by RevMan v5.3.0.

Results: A total of ten RCTs articles including 663 patients were studied. The analysis demonstrated that the n-3 PUFAs group significantly reduced levels of interleukin-6 (IL-6) (P = 0.001), C-reactive protein (CRP) (P < 0.00001), tumor necrosis factor-ɑ (TNF-α) (P = 0.0003) compared with the control group. and higher levels of CD4⁺T cells (P = 0.03), CD8⁺T cells (P = 0.02) and CD4⁺/CD8⁺ratio (P = 0.03) compared with the control group. but there was no significant difference in infection complications rate (P = 0.50) and the level of prealbumin (P = 0.80), albumin (P = 0.21), retinol-binding protein(P = 0.80) between the two groups. In addition, the n-3 PUFAs group significantly reduced the length of hospital stay (P = 0.007).

Conclusion: Our meta-analysis shows that n-3 PUFAs can effectively improve the immune function of patients undergoing gastrointestinal cancer surgery, reduce inflammatory response and reduce the length of hospital stay, But it has no significant impact on the incidence of infectious-related complications and the level of nutrient protein.

Keywords: Gastrointestinal cancer; Immune function; Inflammatory response; Omega-3 fatty acids.