P565 - EMERGING ROLE OF HOME PARENTERAL NUTRITION IN MALIGNANT INTESTINAL FAILURE: A NEW FRONTIER IN PALLIATIVE CARE?

P565

EMERGING ROLE OF HOME PARENTERAL NUTRITION IN MALIGNANT INTESTINAL FAILURE: A NEW FRONTIER IN PALLIATIVE CARE?

G. Mohácsi^1,*, M. Zsilák-Urbán ¹, S. Lada ¹, D. Illés ¹, M. Tajti ¹, L. Czakó¹

¹ Department of Medicine,, Center of Gastroenterology, Szeged , Hungary

Rationale: Patients with malignant intestinal failure are at high risk of malnutrition due to impaired enteral nutrient absorption, which adversely affects survival, quality of life, and the effectiveness of oncologic treatment. This study aims to assess the clinical effectiveness and feasibility of home parenteral nutrition (HPN) as a component of supportive care in patients with advanced cancer.

Methods: We conducted a retrospective observational study involving 17 patients with malignant intestinal failure between 2015 and 2025. The effectiveness of home parenteral nutrition (HPN) was assessed using anthropometric parameters (body weight, BMI, skeletal muscle mass), biochemical markers (serum albumin, lymphocyte count, C-reactive protein), and nutritional indices including the Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI). Survival analysis was performed using the Kaplan–Meier method and Cox proportional hazards regression. 

Results: Mean age was 59.1 ± 11.9 years; 82.3% were female. Indications for HPN were: type 1 short bowel syndrome (29.4%), type 2 (11.8%), and tumor-related obstruction (58.8%). Based on GLIM criteria, 64.7% were malnourished. Median survival was 9 months. No significant changes occurred in body weight, BMI, muscle mass, or ECW during HPN. Survival was not significantly associated with NRI, GNRI, or PNI values; however, higher Glasgow Prognostic Score (GPS) correlated with poorer outcomes. Four complications were recorded: one port malfunction, one case of skin necrosis, and two catheter infections.

Conclusion: HPN is an effective and low-risk method for maintaining the nutritional status of oncology patients with intestinal failure, provided that appropriate training and support are ensured. Further prospective studies are needed to clarify the long-term impact of HPN in this population.

Disclosure of Interest: None declared