PD761 - MULTIDISCIPLINARY DELPHI CONSENSUS IDENTIFYING PRIORITIES FOR REAL-WORLD NUTRITIONAL CARE IN UPPER GASTROINTESTINAL CANCER

PD761

MULTIDISCIPLINARY DELPHI CONSENSUS IDENTIFYING PRIORITIES FOR REAL-WORLD NUTRITIONAL CARE IN UPPER GASTROINTESTINAL CANCER

F. X. Palmas Candia^1,*, V. Pacheco Barcia², A. A. Alayón Afonso³, O. Abdel-Lah Fernandez⁴, Y. Lupiañez Perez⁵, N. Martinez Lago⁶, A. Hernandez Machancoses⁷, J. M. Guardia Baena⁸

¹Nutrition Support Unit,o  Endocrinology and Nutrition Department, Vall d´Hebron University Hospital, Barcelona, ²Medical Oncology, La Luz University Hospital, Madrid, ³Radiotherapy Oncology, Doctor Negrin University Hospital, Las Palmas de Gran Canaria, ⁴General and Digestive Surgery, University Health Care Complex, Salamanca, ⁵Nurse in Radiotherapy Oncology, Virgen de la Victoria University Hospital, Malaga, ⁶Medical Oncology, Santiago de Compostela University Hospital, Santiago de Compostela, ⁷Radiotherapy Oncology, General Hospital, Valencia, ⁸Endocrinology and Nutrition, Virgen de las Nieves Hospital, Granada, Spain

Rationale: Nutritional management in patients with upper gastrointestinal cancer (GIC) remains heterogeneous despite available international  multidisciplinary (MD) guidelines. Discrepancies persist in MD care, including assessment, perioperative management, and follow-up, reflecting the lack of integrated, tumor-specific recommendations for real-world practice. To address this gap, a MD Delphi consensus was conducted.

Methods: A two-round Delphi study was conducted with Spanish experts in Endocrinology and Nutrition, Oncology, Surgery, and Oncology Nursing. Based on a literature review, 67 statements covering key domains of nutritional care were developed. Statements were rated on a 9-point Likert scale. Consensus was defined as ≥66.6% agreement within the same tertile as the median. Internal consistency was assessed using Cronbach’s alpha.

Results: A total of 38 experts participated (95% response rate), achieving consensus in 98.5% of statements with high internal consistency (Cronbach’s α = 0.897. The consensus identified key priorities for clinical practice, including systematic integration of body composition assessment—using computed tomography when available and bioimpedance vector analysis as an alternative—implementation of structured nutritional prehabilitation, and a symptom-oriented approach addressing dysphagia, malabsorption, and dumping syndrome. Telemedicine and artificial intelligence were also recognized as emerging tools to improve follow-up, adherence, and continuity of care.

Conclusion: This multidisciplinary Delphi consensus complements existing guidelines by identifying key priorities and addressing areas not fully standardized in nutritional care for upper GIC. It supports a structured, clinically actionable and implementable care pathway based on real-world practice and multidisciplinary agreement.

Disclosure of Interest: None declared