A316 CANADIAN CANCER PATIENTS ON HOME TOTAL PARENTERAL NUTRITION (HTPN): A 10-YEAR ASSESSMENT
Bibliographic record
Abstract
For cancer patients with intestinal failure, malnutrition is a common and recognized predictor of poor prognosis. While home total parenteral nutrition (HTPN) may improve nutritional status, quality of life, and potentially survival, its use in this population varies considerably across different countries. In Canada, the number of cancer patients receiving HTPN has increased significantly over the last decade. However, there seems to be a disparity among provinces regarding access and indication for HTPN. The objectives of the present study were to characterize the population of cancer patients on HTPN across Canada and assess clinical outcomes using data from the Canadian HTPN Registry. This retrospective analysis included all cancer patients enrolled in the Canadian HTPN Registry from 2005 to 2016. Patient demographics, nutritional status, Karnofsky Performance Status (KPS), tumour type, and HTPN duration were described at both national and provincial levels. Kaplan-Meier survival curves were analyzed by tumour type and province with the log-rank test. There were 164 cancer patients on HTPN (107 females, 57 males; mean age 54.9 ± 13.0), which comprised 22.6% of the total HTPN population. The majority of cancer patients on HTPN were from Ontario (54.3%) and Alberta (41.5%). The most common tumour categories were gastrointestinal (54.2%) and gynecological (31.8%). Patients on HTPN for ≥ 3 months had a higher baseline KPS (65 vs. 50; p < 0.05) and albumin (33.5 vs. 25.0 mmol/L; p < 0.05) compared to those on HTPN for < 3 months. There were no differences in survival based on location of tumour (p = 0.887), but patients in Ontario had better median survival compared to those in Alberta (11.3 vs. 7.1 months; p = 0.037). Ontario had a significantly higher proportion of cancer patients with short bowel syndrome (32.5% vs. 8.8%; p < 0.001), mucosal defects (7.9% vs 0%; p = 0.019), and/or surgical complications (21.8% vs. 4.4%; p < 0.001) relative to Alberta. This is the first study to assess HTPN use in cancer patients across Canada. Cancer is now a relatively frequent indication for HTPN but primarily in Ontario and Alberta, suggesting potential access issues in other provinces. Patients with greater baseline functional and nutritional status received HTPN for longer periods of time, which may indicate better prognosis. The greater survival in Ontario may be due to more selective HTPN indications. This study serves as a first step in optimizing the management of the growing population of cancer patients on HTPN. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".