O062 - MAJOR ADVERSE NUTRITIONAL EVENTS (MANE): A COMPOSITE OUTCOME FOR EARLY NUTRITIONAL RISK IN COLORECTAL CANCER SURGERY

O062

MAJOR ADVERSE NUTRITIONAL EVENTS (MANE): A COMPOSITE OUTCOME FOR EARLY NUTRITIONAL RISK IN COLORECTAL CANCER SURGERY

F. X. Palmas Candia^1,*, F. J. Sanchez-Torralvo², R. Fernandez-Jimenez³, F. Mucarzel ¹, V. Soria Utrilla², P. Guirado Peláez⁴, G. Olveira⁵, R. Burgos¹, J. M. Garcia Almeida⁴

¹1Nutrition Support Unit, Endocrinology and Nutrition Department, Hospital Universitari Vall d’Hebron, Barcelona, ²Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, ³6Department of Endocrinology and Nutrition, ⁴Endocrinology and Nutrition Department, Virgen de la Victoria University Hospital, ⁵Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga, Malaga, Spain

Rationale: Body composition (BC) influences surgical outcomes in colorrectal cancer (CRC), yet current thresholds rely on late endpoints such as mortality. We defined Major Adverse Nutritional Events (MANE), as a composite outcome capturing early postoperative events to enable risk stratification through clinically relevant cut-offs and timely intervention.

Methods: Prospective multicenter study including 502 patients with CRC undergoing elective surgery. MANE was defined as a composite endpoint integrating complication severity (Clavien–Dindo), hospital stay, discharge, 90-day mortality. Preoperative assessment included bioelectrical impedance(phase angle, PA), nutritional ultrasound (rectus femoris, RF), handgrip strength (HG), and computed Tomography (CT) derived BC using automated segmentation software (FocusedON-BC). Tissue quality was assessed by radiodensity (Hounsfield Units, HU). Sex-stratified analyses and multivariable logistic regression were performed.

Results: MANE occurred in 54.0%. In men, worsening MANE was associated with lower PA (5.82 vs 4.80°, p<0.001), RF area (4.33 vs 3.10 cm², p=0.006), HG (35.2 vs 29.0 kg, p=0.004), and muscle radiodensity (32.7 vs 22.2 HU, p=0.004). In women, MANE was associated with lower PA (5.10 vs 3.90°, p<0.001), reduced RF-area  (3.36 vs 1.98 cm², p=0.023), and subcutaneous adipose tissue depletion (197.9 vs 66.4 cm², p<0.001). In men, higher lean muscle radiodensity was associated with lower risk (OR 0.69 per +10 HU; p=0.011), whereas in women, higher relative visceral fat percentage increased risk (OR 1.34 per +10%; p=0.038).

Conclusion: MANE integrates clinically relevant postoperative events, enabling early identification of surgical nutritional risk and a window for intervention. Advanced morphofunctional assessment identifies sex-specific risk phenotypes, with muscle quality impairment in men and adipose tissue redistribution in women.

Disclosure of Interest: None declared