Factors influencing analysis of the efficacy of probiotics combined with enteral nutrition in postoperative patients with colorectal cancer

Abstract

BACKGROUND

Colorectal cancer is a prevalent malignancy with suboptimal postoperative recovery outcomes. Enhancing recovery and prolonging disease-free survival remains a critical challenge. This study investigates factors influencing the efficacy of probiotics combined with enteral nutrition in postoperative patients with colorectal cancer.

AIM

To identify predictors of therapeutic efficacy for probiotics combined with enteral nutrition in postoperative patients with colorectal cancer.

METHODS

A retrospective study was conducted with 511 patients with colorectal cancer who underwent surgery and received probiotics and enteral nutrition from January 2022 to March 2025. Patients were categorized into the “good efficacy group” (n = 279) and “poor efficacy group” (n = 232) based on outcomes observed 3 months post-surgery. Variables assessed included gut microbiota composition, nutritional intake, immune and inflammatory markers, and demographic characteristics.

RESULTS

Patients with favorable outcomes were typically younger, had higher caloric, protein, and fiber intake, and displayed enhanced intestinal mucosal barrier function with elevated levels of Bifidobacterium and Lactobacillus. Immune markers such as immunoglobulin A, immunoglobulin M, immunoglobulin G, and CD4+/ CD8+ T-cell ratios were significantly higher in the good efficacy group. High numbers of Fusobacterium nucleatum and Bacteroides fragilis and levels of tumor necrosis factor-alpha and interleukin-6 were associated with poor efficacy. Multivariate analysis identified age, tumor node metastasis stage, protein intake, and gut microbiota composition as significant predictors of therapeutic success.

CONCLUSION

The efficacy of combining probiotics with enteral nutrition in postoperative patients with colorectal cancer was influenced by age, nutritional intake, microbiota balance, immune status, and inflammatory markers.

Keywords: Colorectal cancer; Probiotics; Enteral nutrition; Postoperative recovery; Gut microbiota; Immune markers

Core Tip: This retrospective study identifies key predictors influencing the efficacy of probiotics combined with enteral nutrition in 511 postoperative colorectal cancer patients. Younger age, higher protein intake, balanced gut microbiota (elevated Bifidobacterium, reduced Fusobacterium nucleatum), and improved immune markers independently correlated with better outcomes. These findings highlight modifiable factors—nutritional optimization and microbiota modulation—for enhancing recovery. Multivariate analysis confirmed age, tumor node metastasis stage, protein intake, and microbial composition as significant prognostic indicators.