Review article/Meta-analysis
Published: 2025-05-06

The impact of immunonutrition in head and neck cancer surgery: a systematic review with meta-analysis

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, University of Brescia
Department of Statistics, Informatics, Applications, University of Florence, Florence, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy
Head and neck cancer Immunonutrition Enteral nutrition Meta-analysis Systematic review

Abstract

Objective

Malnutrition is common among patients undergoing surgery for head and neck cancer (HNC), leading to higher postoperative complications and mortality rates. Immunonutritional intervention shows potential in reducing these risks by enhancing immune function and aiding wound healing.

Methods

A systematic review and meta-analysis were conducted according to PRISMA guidelines. Nineteen randomized controlled trials involving 1196 participants undergoing HNC surgery were included. Studies comparing immunonutrition with standard care were analyzed for outcomes including fistula formation, wound infections, other infections, and length of hospital stay.

Results

Immunonutrition significantly reduced postoperative fistulas and shortened hospital stays compared to standard care. The impact on wound and systemic infections was inconclusive. Immunonutrition was generally well-tolerated, with no significant increase in adverse events.

Conclusions

These findings highlight the potential benefits of immunonutrition in improving postoperative outcomes for HNC patients. However, the variability in study outcomes and quality limitations call for further research to clarify the specific efficacy, long-term effects, and cost-effectiveness of immunonutrition in this context.

Affiliations

Claudia Lodovica Modesti

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy

Davide Mattavelli

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy

Gabriele Testa

Unit of Otorhinolaryngology – Head and Neck Surgery, University of Brescia

Lorenzo Tofali

Department of Statistics, Informatics, Applications, University of Florence, Florence, Italy

Cesare Piazza

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy

Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2025

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