PP101 - PANCREATIC CANCER PATIENTS NUTRITIONAL MANAGEMENT IN FRANCE: A NATIONWIDE ANALYSIS

PP101

PANCREATIC CANCER PATIENTS NUTRITIONAL MANAGEMENT IN FRANCE: A NATIONWIDE ANALYSIS

G. Ulmann^1,*, A. Bayle², D. Quilliot³, A. Paty⁴, P. Senesse⁵, T. Voron⁶, C. David-Baseï¹, M. Saidani¹, G. Mercier⁷

¹Nutricia, Rueil Malmaison, ²Biostatistics ad Epidemiology, Gustave Roussy, Villejuif, ³Nutritional Assistance Unit and Transversal Nutrition Unit, CHRU de Nancy, Nancy, ⁴Centre Henri Becquerel, Rouen, ⁵Department of Supportive and Palliative Care, ICM, Montpellier, ⁶General and Digestive Surgery Department, APHP, Paris, ⁷Public Health, CHU Montpellier, Montpellier, France

Rationale: Pancreatic cancer frequently leads to malnutrition, worsening overall patient health and reducing treatment tolerance. In France, nutritional practices are highly variable and poorly documented. This study is the first to analyze nutritional management in French hospitals using national database (SNDS).

Methods: A retrospective study of SNDS data included adults diagnosed with incident localized pancreatic cancer in 2023, followed for 12 months from their first hospitalization for chemotherapy or surgery. Prevalence and severity of coded malnutrition, and nutritional management (hospital and home enteral/parenteral nutrition [EN/PN], oral supplements) were assessed. Timing between index hospitalization and first malnutrition code was analyzed. Nutritional care practices were evaluated across the 32 hospitals with the highest rates of initial surgeries by dividing them into two groups based on the median rate of surgery (chi2 test).

Results: 4,783 patients were included in 482 hospitals; malnutrition was coded in 47.8% and was severe in 30%. In hospital, 4.8% had PN and 2.5% EN; at home, 12% had PN, 7.4% enteral nutrition, and 75% received oral supplements. Malnutrition was associated with chemotherapy and receiving nutritional support (p<0.001) but not with surgery (p=0.8). In hospitals with the highest rates of surgeries, the delay between inclusion and diagnosis of malnutrition was shorter (54 vs 73 days, p = 0.005), the percentage of patients having home EN was higher (10 vs 5.7%, p = 0.012) and the percentage of patients having hospital PN was smaller (0% vs 4.6%, p=0.012).

Conclusion: Malnutrition affects many patients with pancreatic cancer, yet current approaches to nutritional management differ considerably across institutions. For example, although ESPEN recommends EN, some hospitals continue to prefer PN, which underscores the need for further education.

Disclosure of Interest: G. Ulmann Other: Employee of Danone, A. Bayle Consultant for: Bayer, Sanofi, Roche, Nutricia, D. Quilliot Consultant for: Nutricia, A. Paty Consultant for: Nutricia, P. Senesse Consultant for: Baxter, B Braun, Elivie, Fresenius Kabi, Nestle Health Science, NHC, Nutricia, Pfizer, Servier, Valea, T. Voron Consultant for: BMS, Nutricia, Baxter, AstraZeneca, Fresenius Kabi, C. David-Baseï Other: Employee of Danone, M. Saidani Other: Employee of Danone, G. Mercier Consultant for: Nutricia