PP434 - CT-BASED BODY COMPOSITION MONITORING IN PATIENTS WITH ACTIVE MALIGNANCY RECEIVING HOME PARENTERAL NUTRITION: A RETROSPECTIVE STUDY

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PP434

CT-BASED BODY COMPOSITION MONITORING IN PATIENTS WITH ACTIVE MALIGNANCY RECEIVING HOME PARENTERAL NUTRITION: A RETROSPECTIVE STUDY

M. Perelmuter1,*, D. Zecharia1, R. Anbar1, R. Kessner2,3, L. Deutsch3,4

1Nutrition and Dietetic Department, 2Department of Radiology, Tel Aviv Sourasky University Medical Center, 3Gray Faculty of Medical & Health Sciences, Tel Aviv University, 4Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky University Medical Center, Tel Aviv, Israel

 

Rationale: Body mass index (BMI) may not detect muscle loss in patients receiving home parenteral nutrition (HPN). We evaluated whether computed tomography (CT) derived skeletal muscle index (SMI) better captures longitudinal body composition changes in this population.

Methods: A retrospective cohort study of adults with active malignancy initiated on HPN (2022–2026) and treated for ≥3 months. CT-derived SMI at lumbar vertebra 3 (L3) and BMI were assessed at HPN initiation and after 3 months; low muscle mass was defined by sex-specific cutoffs1. BMI and SMI changes were compared using paired t-test and survival was analyzed by log-rank and Cox regression. 

Results: Of 27 patients included, 40.7% were female; median age was 58.8 years (IQR 50.2–71.8), BMI was 19.8 kg/m² (IQR 17.1–21.9), and SMI was 37.0 cm²/m² (IQR 35.2–41.2). Overall, 85.2% were receiving active oncologic treatment and 88.9% had low muscle mass at HPN initiation. After 3 months, BMI remained stable (median change 0.0%, IQR -4.4–9.5%; p=0.838), while SMI declined by 5.3% (IQR -16.4–6.5%; p=0.083). Muscle loss occurred in 59.3%, including 66.7% of those with stable/increased BMI. During a median follow-up of 211 days (IQR 135–429), 88.9% died. Greater SMI decline was associated with increased mortality risk (HR 1.040 per 1% decrease, p=0.006).

Conclusion: In patients with active malignancy receiving HPN, BMI stability did not exclude skeletal muscle loss. CT-derived SMI identified clinically relevant changes not captured by BMI and was associated with survival.

References: 1Lancet Oncol. 2008 Jul;9(7):629-35.

Disclosure of Interest: None declared