PD825 - A PROSPECTIVE COMPARISON OF THE NUTRITIONAL STATUS IN PATIENTS WITH PANCREATIC ADENOCARCINOMA AND PANCREATIC NEUROENDOCRINE TUMORS.

PD825

A PROSPECTIVE COMPARISON OF THE NUTRITIONAL STATUS IN PATIENTS WITH PANCREATIC ADENOCARCINOMA AND PANCREATIC NEUROENDOCRINE TUMORS.

P. Patil^1,*, S. Sundaram¹, A. Kale¹, S. Mehta¹, V. Chaudhari², M. Bhandare², V. Ostwal³, A. Ramaswamy³, P. Bhargava³, A. Puranik⁴, S. Shrikhande⁵

¹Department of Digestive Diseases and Clinical Nutrition, ²Department of Surgical Oncology, ³Department of Medical Oncology, ⁴Department of Nuclear Medicine, Tata Memorial Hospital, ⁵Department of GI and HPB Surgery, Gleneagles Hospital, Mumbai, India

Rationale: Malnutrition is common in patients with Pancreatic adenocarcinoma (PAC). Pancreatic Neuroendocrine tumors (PNETs) though previously considered uncommon, are increasingly being diagnosed and their malnutrition burden is unknown.

Methods: In this prospective study we assessed malnutrition prevalence in patients with pancreatic tumors. Consecutive untreated patients with histologically confirmed PAC or NET or operable PAC on imaging were recruited over 2.5 years at a referral cancer center. We report a preliminary analysis of the baseline assessment of the first 450 patients.

Results: 404 patients had PAC and 46 had PNET. Patients with PAC were older than those with PNET (mean 60.5 years vs. 51.1 years) and males predominated (69% of PAC and 73% of PNET). An ECOG-PS of 0 or 1 was seen in 85% PAC and 98% PNET. Diabetes Mellitus was commoner in patients with PAC (50% vs. 33%). Patients with PAC were more symptomatic than those with PNET (anorexia 46% vs. 22%, weight loss 31% vs. 20% and jaundice 35% vs. 17%). Operable disease was seen in 20% PAC and 33% PNET at initial MDT assessment. 
CA-19.9 levels >1000 U/ml and albumin levels < 3.5 g/dL were commoner in PAC than PNET (56% vs 7% and 25% vs. 9% respectively). Malnutrition assessed by Subjective Global Assessment (SGA) was commoner in patients with PAC (81% - 45% SGA B, 36% SGA C) as compared to those with PNET (66% - 46% SGA B, 20% SGA C). On multivariate logistic regression analysis adjusted for age and gender, malnutrition was significantly associated with PAC (adjusted OR 2.19, 95%CI 1.09-4.40, p=0.028).  

Conclusion: Malnutrition was present in 81% of patients with PAC and 66% with PNET at diagnosis. Compared to PAC, PNET patients were younger, had less diabetes mellitus, fewer symptoms, better ECOG PS, more operable disease and more often, normal albumin levels.

Disclosure of Interest: None declared