Study
Immune-Enhancing Nutrition and Outcomes After Radical Cystectomy: A Randomized Clinical Trial.
A 203-patient phase 3 trial found no 30-day complication reduction from perioperative immunonutrition containing omega-3, arginine and nucleotides.
Summary Can a special nutrition drink prevent problems after bladder cancer surgery? Show / hide ↓
Researchers studied 203 adults with bladder cancer having radical cystectomy, an operation to remove the bladder. They randomly assigned them to drink either a standard nutrition drink or an immunonutrition drink, meaning one with added arginine, omega-3 fats, and other nutrients, three times daily for five days before and after surgery. Among 178 people with follow-up information, 62% of the special-drink group and 58% of the standard-drink group had a health problem within 30 days. More serious problems were also similar, and there was no clear difference in how many people were alive or cancer-free after two years.
What this means for you: This study does not show that the special drink prevents complications after bladder surgery. You can ignore it as a reason to buy omega-3 supplements, especially because the study tested a mixture of ingredients rather than omega-3 alone.
solid evidenceSWOG S1600 was a multicentre, double-blind phase 3 trial at 13 US academic and community sites. It randomised 203 adults with bladder cancer scheduled for radical cystectomy to standard oral nutrition or an immunonutrition drink containing added l-arginine, omega-3 fatty acids, and dietary nucleotides. Drinks were taken three times daily for 5 days before and after surgery. The primary endpoint was any 30-day complication of Clavien-Dindo grade 1 or higher. Seventeen participants withdrew and 8 had no 30-day data, leaving 178 evaluable participants: 90 immunonutrition and 88 standard nutrition. Complications occurred in 62.2% of the immunonutrition group and 58.0% of controls (odds ratio 1.18, 95% CI 0.64-2.18). High-grade 30-day complications were 11.1% and 12.5%, respectively (odds ratio 0.86, 95% CI 0.34-2.17). Two-year overall survival was 87.4% versus 78.2%, and disease-free survival was 77.0% versus 67.5%, but neither difference was statistically significant. This well-sized hard-endpoint trial does not show that the multi-ingredient formula reduces postoperative complications. It also cannot isolate any effect of omega-3 fatty acids.
Perioperative specialised immunonutrition did not reduce 30-day complications compared with standard oral nutrition.
The intervention combined omega-3 fatty acids with l-arginine and dietary nucleotides, so it was not an omega-3-only test. It involved people undergoing radical cystectomy, and the survival differences were not statistically significant.
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