Bao MD, Huang F, Cheng P, Zheng ZX. Effects of long-term immunonutrition on postdischarge colorectal cancer surgery patients. World J Gastrointest Surg 2026; 18(6): 118979 [DOI: 10.4240/wjgs.118979]
Corresponding Author of This Article
Zhao-Xu Zheng, MD, PhD, Professor, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. 3213780037@163.com
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Nutrition & Dietetics
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research-article
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Bao MD, Huang F, Cheng P, Zheng ZX. Effects of long-term immunonutrition on postdischarge colorectal cancer surgery patients. World J Gastrointest Surg 2026; 18(6): 118979 [DOI: 10.4240/wjgs.118979]
World J Gastrointest Surg. Jun 27, 2026; 18(6): 118979 Published online Jun 27, 2026. doi: 10.4240/wjgs.118979
Effects of long-term immunonutrition on postdischarge colorectal cancer surgery patients
Man DL Bao, Fei Huang, Pu Cheng, Zhao-Xu Zheng
Man DL Bao, Fei Huang, Pu Cheng, Zhao-Xu Zheng, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
Author contributions: Bao MDL, Huang F, Cheng P, and Zheng ZX designed the overall concept and outline of the manuscript; Bao MDL and Huang F contributed to the discussion and design of the manuscript; Bao MDL and Cheng P contributed to the writing and editing of the manuscript, illustrations, and review of the literature; and all the authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 23/086-3825.
Clinical trial registration statement: This study is registered at www.chictr.org.cn. The registration identification number is ChiCTR2300071078.
Informed consent statement: All study participants or their legal guardians provided informed consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. Nestlé Health Science China funded the immunonutrition products and partially supported the research activity concerning this study. Nestlé Health Science was not involved in the study design, collection, interpretation, or analysis of data, or the writing of the article. The authors declare no other conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at 3213780037@163.com.
Corresponding author: Zhao-Xu Zheng, MD, PhD, Professor, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. 3213780037@163.com
Received: January 19, 2026 Revised: January 30, 2026 Accepted: April 7, 2026 Published online: June 27, 2026 Processing time: 150 Days and 23.1 Hours
Abstract
BACKGROUND
Nutritional deficiency and immunosuppression after radical colorectal cancer (CRC) surgery persist long term, rather than being confined to the immediate postoperative period, and may even worsen after hospital discharge. However, most research exploring immunonutrition (IMN) efficacy has been concentrated on the short-term perioperative phase, culminating in a significant dearth of long-term evidence for its effects on the immunonutritional status of postdischarge CRC patients.
AIM
To assess the influence of prolonged oral administration postdischarge on the immunonutritional status of patients undergoing radical CRC surgery.
METHODS
In June 2023, a two-parallel-arm, multicenter randomized controlled trial (ChiCTR2300071078) was launched in CRC patients across 20 tertiary Chinese medical centers. For a consecutive 30 days postdischarge, patients in the intervention arm received IMPACT Oral® - a novel postoperative immunomodulatory formula, an IMN-fortified enteral feed - as a supplement to their regular diet, whereas the control arm was given a conventional nutritional formula. Primary endpoints were post-intervention nutritional and immunological parameters, and the secondary endpoint was the rate of postoperative infectious complications.
RESULTS
We collated and analyzed data from the trial’s lead center up to May 2024, with a total of 447 patients enrolled. Baseline demographic characteristics were well balanced between the two study arms (P > 0.05). After intervention, significant intergroup differences were observed in Patient-Generated Subjective Global Assessment scores and serum albumin concentrations (P < 0.05). Moreover, the IMN group had a significant post-intervention elevation in absolute lymphocyte count and the levels of immunoglobulin G and immunoglobulin M compared with the control group (all P < 0.05). Although the total incidence of complications did not differ significantly between the two arms, the IMN group presented a markedly lower incidence of postoperative infectious complications (P < 0.05).
CONCLUSION
The present trial demonstrated that prolonged post-surgical oral IMN supplementation in patients with CRC resulted in improved nutritional status, enhanced immune function, and a reduced incidence of postoperative infectious complications.
Core Tip: This randomized controlled trial compared long-term immunonutrition (IMN) with conventional oral nutritional supplements in postdischarge colorectal surgery patients. Radical colorectal cancer surgery induces persistent nutritional deficiency and immunosuppression that may worsen after discharge, yet most IMN studies focus on the short-term perioperative phase, resulting in a notable lack of long-term postdischarge data. After the intervention, nutritional and immunological parameters were comparable between the groups, while the IMN group had a significantly lower incidence of postoperative infectious complications. Our findings confirmed that prolonged postoperative oral IMN optimizes nutritional profiles, enhances immune competence, facilitates subsequent therapy preparation and reduces infection risk in colorectal cancer patients.
