LB131 - PROSPECTIVE STUDY OF PATIENTS WITH PERITONEAL CARCINOMATOSIS UNDERGOING CYTOREDUCTIVE SURGERY AND HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY: INFLUENCE OF NUTRITIONAL STATUS ON CLINICAL OUTCOMES

LB131

PROSPECTIVE STUDY OF PATIENTS WITH PERITONEAL CARCINOMATOSIS UNDERGOING CYTOREDUCTIVE SURGERY AND HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY: INFLUENCE OF NUTRITIONAL STATUS ON CLINICAL OUTCOMES

C. Serrano¹, M. Arnoriaga^1,*, I. Bretón¹, C. Velasco¹, M. Carrascal¹, M. L. Fernández-Vázquez², A. Bielza¹, T. Hernández¹, B. Rodríguez¹, C. Cuerda¹

¹Nutrition Unit, ²General Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Rationale: Peritoneal carcinomatosis (PC) presents high rates of malnutrition. This study assesses the impact of nutritional status on clinical outcomes in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods: Prospective cohort of patients included in a prehabilitation program before CRS-HIPEC. Complete nutritional assessment (anthropometry, dynamometry, BIA) was performed at 1 month before surgery, at admission, and at 1 and 3 months postoperatively. Immunomodulatory ONS were prescribed preoperatively and high-protein, high-calorie ONS postoperatively. Data are expressed as median [IQR]. Friedman and Spearman tests were used. 

Results: We included 38 patients (20F/18M; 60 yrs [19.5]). PC origins: colon (14), ovarian (10), gastric (4), appendix (4), others (6). Presurgical peritoneal carcinomatosis index (PCI) 10 [20]. BMI pre-surgery: 24.9 [8.5] kg/m². Hospital stay: 11.5 [9] days; Parenteral nutrition: 5.5 [9.2] days. 14 patients (36.8%) had complications: ileus (2), evisceration (2), pancreatic fistula (2), anemia (2), perforation (1), wound dehiscence (1), urinary tract infection (1), hemorrhage (1), pelvic hematoma (1), hypomagnesemia (1). Pre-surgery: Phase angle (PhA) correlated with age (ρ=-0.413; p=0.010), grip strength (ρ=0.582; p=0.001), and skeletal muscle index (SMI) (ρ=0.540; p<0.001). Grip strength correlated with SMI (ρ=0.632; p<0.001) and ICU stay (ρ=-0.354; p=0.032). Nutritional and functional status worsened after CRS+HIPEC and remained impaired at 3 months.

Conclusion: CRS+HIPEC leads to sustained deterioration in nutritional and functional parameters. Grip strength correlated with ICU stay. Neither PhA nor grip strength correlated with postoperative complications.

Disclosure of Interest: None declared