Peri-operative nutrition in cancer patients [Nutrition péri-opératoire chez les patients cancéreux]

In oncologic surgery, artificial nutrition (AN) should be considered as an essential tool in the management of malnourished or catabolic patients. Its performance can be remarkable, but its objective is only fully achieved when the prescription is perfectly adapted to the patient's need and is regularly monitored. As any other therapeutic tool, AN carries costs and some adverse effects and thus it should be prescribed based on precise indications. The use of the enteral feeding should be preferred to parenteral nutrition whenever there is a functioning gut. The clinical use of new nutritional substrates is giving exciting and promising results. In elective cancer patients the pre- and peri-operative approaches appear the most rational and demonstrated clear benefits on clinical outcome. Indeed, the results suggest that immunonutrition is effective only in subjects who are successfully fed or when an adequate amount of substrates is achieved.