Home parenteral nutrition and survival in late-stage cancer: retrospective cohort study

OBJECTIVES: Evidence suggests that home parenteral nutrition (HPN) can prolong survival and improve quality of life in selected patients with late-stage cancer. This study aims to identify clinical characteristics associated with the survival of Taiwanese patients with late-stage cancers receiving HPN through retrospective analysis. METHODS: A retrospective study of 410 Taiwanese patients with late-stage cancer unresponsive to at least three treatment lines was performed to compare survival outcomes between those receiving HPN and those receiving palliative care alone (2010-2024), matched by sex, cancer type and treatment history. Demographic, clinical, nutritional, inflammatory, performance status (PS) and do-not-resuscitate (DNR) status data were analysed using univariate and multivariate survival analyses. RESULTS: Compared with those in the palliative care group, patients in the HPN group were younger, with fewer having Eastern Cooperative Oncology Group PS (ECOG PS) score >2, fewer DNR consents and were more likely to be receiving ongoing cancer treatment. Median survival was significantly longer in the HPN group (77 vs 17 days, p2, DNR consent and modified Glasgow Prognostic Score of 2 were independently associated with shorter survival, while the use of HPN was linked to reduced mortality risk. The negative impact of DNR consent on survival was more pronounced in patients aged