The Impact of Home Parenteral Nutrition on Survival and Quality of Life in Patients with Intestinal Failure and Advanced Cancer: A Comprehensive Review

Background and Aims: Home parenteral nutrition (HPN) is essential in the management of chronic intestinal failure (CIF) and malignant bowel obstruction (MBO), particularly in cases where enteral feeding is not feasible. This review examines the evidence from 34 studies to evaluate the impact of HPN on survival and quality of life (QoL) in patients with MBO, CIF, and advanced cancer, as well as to identify clinical predictors of survival and address psychosocial challenges. Methods: A comprehensive review was conducted of 34 studies, focusing on the use of HPN in patients with MBO, CIF, and advanced cancer. Data were analyzed for survival outcomes, QoL metrics, and predictors of survival, including performance status, albumin levels, and the continuation of chemotherapy. The psychosocial aspects of HPN therapy were also assessed, particularly its influence on patient's daily lives and mental health. Results: Key predictors of improved survival included good performance status, higher albumin levels, and the ability to continue chemotherapy. While HPN extended survival in many cases, its impact on QoL varied significantly. Psychosocial challenges, including lifestyle disruption and mental health strain, were common among long-term HPN patients, underscoring the need for comprehensive patient support. Conclusions: HPN can be a life-sustaining therapy for patients with CIF, MBO, and advanced cancer, but its success depends on careful patient selection and management. Identifying predictors of survival helps optimize outcomes, while addressing psychosocial challenges is crucial to minimizing the negative impact on QoL. This review highlights the need for a balanced approach to maximize the benefits of HPN.