LB084 - INTESTINAL REMODELING IS ASSOCIATED WITH SYSTEMIC INFLAMMATION AND CANCER CACHEXIA IN COLORECTAL CANCER PATIENTS

LB084

INTESTINAL REMODELING IS ASSOCIATED WITH SYSTEMIC INFLAMMATION AND CANCER CACHEXIA IN COLORECTAL CANCER PATIENTS

J. Ferreira De Resende^1,*, M. Andrade¹, F. Formiga², R. Massai³, M. Seelaender¹

¹Cancer Metabolism Research Group, Department of Surgery and Laboratory of Experimental Surgery (LIM 26), Faculdade de Medicina da Universidade de São Paulo, ²Department of Colorectal Surgery, Santa Casa de Misericórdia de São Paulo, ³Gastrointestinal Surgery, Instituto do Câncer Doutor Arnaldo de Carvalho, São Paulo, Brazil

Rationale: Although systemic inflammation is a hallmark of cancer cachexia, the contribution of intestinal structural alterations to this syndrome remains poorly understood. This study investigated intestinal remodeling in colorectal cancer patients with and without cachexia.

Methods: Thirty-four colorectal cancer patients undergoing surgical resection were classified as weight-stable cancer (WSC, n=18) or cancer cachexia (CC, n=16). Anthropometric parameters, body composition by bioelectrical impedance analysis, and serum biochemical markers were evaluated. Non-tumoral distal intestinal margin samples were submitted to hematoxylin-eosin histological analysis. Group comparisons were performed using appropriate statistical tests, with significance set at p<0.05.

Results: Compared with WSC, cachectic patients exhibited weight loss (-14.3±1.4 vs -2.7±0.6%; p<0.001), lower fat-free mass index (16.6±0.4 vs 17.8±0.4 kg/m²; p=0.05), and reduced calf circumference (p≤0.05). Serum albumin levels were lower (4.13±0.16 vs 4.67±0.13 g/dL; p=0.01), whereas C-reactive protein concentrations were higher (36.9±14.2 vs 10.3±3.4 mg/dL; p=0.05). Histological analysis demonstrated reduced intestinal mucosal thickness (p<0.01) and increased submucosal thickness (p=0.04) in cachectic patients, consistent with mucosal atrophy and tissue remodeling. Chronic inflammatory infiltrates and prominent lymphoid aggregates were observed in intestinal samples from cachectic patients.

Conclusion: Our findings suggest an association between cancer cachexia in colorectal cancer and intestinal structural alterations characterized by mucosal atrophy, submucosal remodeling, and local inflammation. These findings suggest that the intestine may contribute to the pathophysiology of cancer cachexia and highlight the importance of integrating intestinal and systemic alterations in patient assessment.

Disclosure of Interest: None declared