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AIM
To collect current practises of parenteral nutrition in patients with advanced incurable cancer with mild to severe intestinal failure by a structured international survey of clinical experts, defined as expectance in advanced cancer care and nutrition.
OBJECTIVES

1. To investigate current practise of parenteral nutrition in patients with advanced incurable cancer and mild to severe intestinal failure.

2.1 To define patients characteristics, based on the new cancer cachexia classification, tackling the gap in clinical guidelines in parenteral nutrition of cancer patients having advanced incurable cancer and mild to severe intestinal failure;
2.1.1 To define indication criteria for parenteral nutrition;
2.1.2 To identify patient characteristics of patients having refractory cancer cachexia.

2.2 To collect current practice of basic cancer cachexia management (“incurable cancer nutrition staging”) as a pre-condition for considering parenteral nutrition in incurable cancer patients.

2.3 To identify outcome criteria defined by experts who prescribe parenteral nutrition.

3. As exploratory objective, an outline for a potential clinical trial of parenteral nutrition (indications, outcomes) is foreseen.

STUDY OUTLINE
The project is a four phase project with survey development, survey conductance, survey analyzes and finally a summary document.

METHODS
A cross-sectional survey, based on case vignettes developed by clinical experts in Palliative Cancer Care and Cancer Cachexia and a literature review, is completed by “all” clinicians who prescribe parenteral nutrition in advanced, incurable cancer patients, from institutions identified through the palliative care, nutrition or cachexia working groups of the four professional societies of oncology (ESMO, MASCC), palliative care (EAPC) and nutrition (ESPEN).