Introduction: Advances in treatment strategies for gastric and esophageal cancer have led to improved long-term outcomes, however the local and systemic effects of tumor growth, neoadjuvant therapies and surgery, results in specific nutritional challenges. Comprehensive nutritional evaluation and support represents a core component of multidisciplinary holistic care for this patient population.
Areas Covered: This review provides a detailed overview of the nutritional challenges in gastric and esophageal cancer, with a focus on malignant obstruction, preoperative optimization and nutrition in survivorship. We discuss the current management options for these challenges, with an overview of the present evidence base, and detail the future therapeutic targets in nutritional support in gastric and esophageal cancer.
Expert Opinion: The advent of bariatric surgery to treat obesity has yielded fascinating insights into the postoperative attenuation of gut hormone signaling that underpins early satiety and persistent weight loss following gastric and esophageal cancer surgery, providing new therapeutic targets. The management of malignant dysphagia and obstruction currently lacks robust evidence, particularly in patient reported outcomes, to support an optimal strategy. The advantages of nutritional optimization in the pre- and immediate postoperative phase are well documented, but the exact regimens to optimize patient outcomes and quality of life are not clear.
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