Nutritional support and immunonutrition in esophageal cancer – From perioperative care to long-term survivorship: A review

Esophageal cancer is recognized as one of the most aggressive malignancies within the digestive system, with global survival rates typically falling below 20%. Malnutrition impacts up to 80% of patients, significantly affecting treatment tolerance, postoperative outcomes, and overall quality of life. Recent advancements in clinical nutrition and immunometabolism have transformed the perception of nutrition from a mere supportive measure to a vital therapeutic component in cancer care. This review synthesizes evidence from studies published between 2010 and 2025, exploring the effects of various nutritional strategies-including enteral, elemental, parenteral, immuno-nutritional, behavioral, and prehabilitative interventions-on metabolism, immune response, and clinical outcomes in patients with esophageal cancer. The findings demonstrate that targeted approaches such as immune-enhancing enteral formulations, omega-3-enriched parenteral nutrition, and structured dietary counseling can mitigate inflammation, preserve muscle mass, enhance treatment adherence, and improve psychological well-being. Overall, the literature supports the perspective of nutrition as a precision-based, integral component of multidisciplinary cancer management. Incorporating nutritional optimization throughout all stages of care-ranging from prehabilitation and perioperative support to survivorship and palliative management-can enhance metabolic resilience, promote faster recovery, and significantly improve the quality of life for individuals diagnosed with esophageal cancer.