PD1041 - IMPACT OF PREOPERATIVE NUTRITIONAL STATUS AND INSURANCE TYPE ON SHORT-TERMOUTCOMES AFTER CURATIVE GASTRECTOMY FOR PRIMARY GASTRIC CANCER

PD1041

IMPACT OF PREOPERATIVE NUTRITIONAL STATUS AND INSURANCE TYPE ON SHORT-TERM

OUTCOMES AFTER CURATIVE GASTRECTOMY FOR PRIMARY GASTRIC CANCER

S. Lee^1,*, H. S. Ahn², D.-S. Han²

¹Department of surgery, Seoul National University Hospital, ²Department of surgery, SMG-SNU Boramae Medical Center, Seoul, Korea, Republic Of

Rationale: We investigated the association of insurance type and preoperative nutritional status with short-term outcomes after curative gastrectomy for gastric cancer.

Methods: We retrospectively reviewed patients who underwent curative gastrectomy for primary gastric adenocarcinoma at Boramae Medical Center between 2018 and 2023. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. CONUT was categorized as normal/mild or moderate/severe. Insurance type was classified as National Health Insurance (NHI) or Medical Aid (MA). Primary outcomes were major 30-day postoperative complications (Clavien-Dindo grade≥III) and 3-month surgical readmission.

Results: Among 556 patients (NHI, n=471; MA, n=85), the MA group had more advanced stage disease than the NHI group. (Stage II/III : 44.7% vs 31.0%, p=0.013). Preoperative nutritional status did not differ by insurance type. Major complications were comparable, but 3-month readmission rate was higher in the MA group. (10.6% vs 4.7%, p=0.029). Compared with the normal/mild CONUT group, the moderate/severe group showed a trend toward higher short-term complications. (5.5% vs 14.3%, p=0.07) and significantly higher 3-month readmission (p=0.003). On multivariable analysis, advanced stage and operative procedure independently predicted readmission. Poor preoperative nutritional status was independently associated with older age and advanced stage.

Conclusion: Socioeconomic vulnerability reflected by insurance type was associated with advanced cancer stage, whereas nutritional status was not associated with insurance type. Although poor nutritional status and insurance type were associated with higher 3-month readmission, advanced stage and operative procedure remained independent predictors. Older age and advanced stage were independently associated with poorer nutritional status.

Disclosure of Interest: None declared