PD1054 - DISTINCT NUTRITIONAL AND BODY COMPOSITION DOMAINS ARE ASSOCIATED WITH DIFFERENT POSTOPERATIVE OUTCOMES AFTER LIVER RESECTION: A MULTICENTRIC PROSPECTIVE COHORT STUDY

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Sep 5, 2026

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DISTINCT NUTRITIONAL AND BODY COMPOSITION DOMAINS ARE ASSOCIATED WITH DIFFERENT POSTOPERATIVE OUTCOMES AFTER LIVER RESECTION: A MULTICENTRIC PROSPECTIVE COHORT STUDY

PD1054

DISTINCT NUTRITIONAL AND BODY COMPOSITION DOMAINS ARE ASSOCIATED WITH DIFFERENT POSTOPERATIVE OUTCOMES AFTER LIVER RESECTION: A MULTICENTRIC PROSPECTIVE COHORT STUDY

L. PEREZ SANTIAGO^1,*, B. Alabadí-Pardiñes², M. Garcés-Albir ^3,⁴, S. Amores Alandi², I. Mora-Oliver³, P. Melgar-Requena⁵, Á. Abad-González⁶, J. M. Ramia⁵, R. Amrani⁷, E. Muñoz-Forner^3,⁴, M. Bellver⁸, I. Castro De la Vega⁹, J. Salinas Gómez¹⁰, S. Palma Milla¹¹, M. Serradilla-Martín¹², F. Losfablos Callau¹³, P. Sánchez-Velázquez¹⁴, M. D. Muns¹⁵, M. Civera Andres², L. Sabater-Ortí^3,¹⁶, D. Dorcaratto³

¹Department of General and Digestive Surgery, Hospital Clinico Universitario. INCLIVA Biomedical Research Institute, Colorectal Surgery Unit, ²Department of Endocrinology and Nutrition. Hospital Clinico Universitario. INCLIVA Biomedical Research Institute, Body Composition Unit, ³Department of General and Digestive Surgery, Hospital Clinico Universitario. INCLIVA Biomedical Research Institute, Liver-Biliary and Pancreatic Surgery Unit, ⁴Department of Anatomy, University of Valencia, Valencia, ⁵Hepatobiliary and Pancreatic Surgery Unit, Department of General and Digestive Surgery, Hospital General Universitario de Alicante, Liver-Biliary and Pancreatic Surgery Unit, ⁶Hepatobiliary and Pancreatic Surgery Unit, Department of General and Digestive Surgery, Hospital General Universitario de Alicante, ⁷Department of Endocrinology and Nutrition. Hospital Clinico Universitario. INCLIVA Biomedical Research Institute, Endocrinology and Nutrition Department, Alicante, ⁸Department of General and Digestive Surgery, Hospital General Universitario de Castellón, Liver-Biliary and Pancreatic Surgery Unit, ⁹Department of Endocrinology and Nutrition. Hospital General Universitario de Castellón, Endocrinology and Nutrition Department, Castellón, ¹⁰Department of General and Digestive Surgery, Hospital La Paz, Liver-Biliary and Pancreatic Surgery Unit, ¹¹Department of Endocrinology and Nutrition. Hospital La Paz, Endocrinology and Nutrition Department, Madrid, ¹²Department of General and Digestive Surgery, Hospital Miguel Servert, Liver-Biliary and Pancreatic Surgery Unit, ¹³Department of Endocrinology and Nutrition. Hospital Miguel Servet, Endocrinology and Nutrition Department, Zaragoza, ¹⁴Department of General and Digestive Surgery, Hospital del Mar, Liver-Biliary and Pancreatic Surgery Unit, ¹⁵Department of Endocrinology and Nutrition. Hospital del Mar, Endocrinology and Nutrition Department, Barcelona, ¹⁶Departmen of Surgery, University of Valencia, Valencia, Spain

Rationale: This study aimed to prospectively evaluate the association between GLIMdefined malnutrition,peripheral muscle mass and adipose tissue distribution with postoperative outcomes after liverresection.

Methods: Prospective multicenter observational study including 99consecutive adult patients undergoing elective liver resection.Nutritional status was assessed preoperatively according to GLIMcriteria using a two-step approach.Calfcircumference was used as a surrogate of peripheral muscle mass.Body composition parameters,including visceral adipose tissue(VAT),intramuscular adipose tissue(IMAT) and muscle radiodensity,were quantified on preoperative computed tomography.Postoperative complications were graded using the Clavien–Dindo classification and the Comprehensive Complication Index(CCI).Multivariable logistic regression models adjusted for clinically relevant covariates were performed.

Results: Twenty-sixpatients developed complications, of whom14.1% had severe complications(CCI>26.2).GLIM-defined moderate/severe malnutrition was associated with increased overall postoperative morbidity(OR:8.35,95%CI1.31-53.05;p=0.02).For each1-cm increase in calf circumference,the odds of severe complications decreased by 49%(OR0.51,95%CI 0.29–0.91;p=0.02),whereas higher VAT was strongly associated with severe complications (OR183.95,95%CI 3.59–9407;p=0.009).In contrast,IMAT,muscle radiodensity,and myosteatosis were not significantly associated with postoperative outcomes.

Conclusion: GLIM-defined malnutrition is associated with overall morbidity,whereas peripheral muscle mass and visceral adiposity are more closely related to severe complications.Multidimensional nutritional assessment may improve perioperative risk stratification and help guide targeted nutritional and prehabilitation strategies.

Disclosure of Interest: None declared