LB088 - NUTRITIONAL RISK ASSESSMENT AND POSTOPERATIVE COMPLICATIONS IN RECTAL CANCER: EVIDENCE FROM THE FOURCOLON-FACTORS STUDY

LB088

NUTRITIONAL RISK ASSESSMENT AND POSTOPERATIVE COMPLICATIONS IN RECTAL CANCER: EVIDENCE FROM THE FOURCOLON-FACTORS STUDY

N. Russo^1,*, G. Porciello¹, A. Luongo¹, P. Rocco¹, F. P. M. Di Carlo¹, S. Coluccia¹, M. Grimaldi¹, F. Nocerino¹, M. D'Amico², L. S. A. Augustin¹, G. D'Amico², A. Minopoli³, E. Cavalcanti³, L. Perna², U. Pace⁴, F. Carbone², A. Luberto², P. Delrio², A. Crispo¹

¹Epidemiology and Biostatistics Unit, ²Colorectal Surgical Oncology Abdominal Oncology Department, ³Laboratory Medicine Unit, ⁴Abdominal Robotic Surgery Unit, Abdominal Oncology Department, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy

Rationale: Geriatric Nutritional Risk Index (GNRI) has emerged as a prognostic marker in colorectal cancer and a reliable tool for assessing nutritional risk. This analysis evaluated the predictive value of GNRI on postoperative complications (POCs) in rectal cancer (RC) patients in FourColon-Factors Study.

Methods: Data were retrospectively collected from patients who underwent rectal anterior resection at Cancer Institute in Naples. The GNRI, derived from serum albumin levels and the ratio of current to ideal body weight, was used to categorized patients as high (GNRI ≤98; H-GNRI) or low nutritional risk (GNRI >98; L-GNRI). Data on 60-day POCs, from medical records, were dichotomized as “none” versus “at least one” complication. The association between GNRI and the onset of the first POC was evaluated using Cox proportional hazards models adjusted for age and gender. The overall survival (OS) analysis was further adjusted for total number of POCs.

Results: Among 291 patients, 12% showed high nutritional risk. H-GNRI patients were mainly female (72.2% vs 42.4%; p=0.001), had a higher incidence of at least one complication (27.8% vs 13.3%; p=0.044), and a longer median length of stay (8.0 [6.0–14.0] vs 6.0 [5.0–10.0] days; p=0.002) than L-GNRI patients. Median time from surgery to the onset of the first POC was 4.0 (1.0-11.0) days. H-GNRI was associated with a significantly increased risk of developing at least one complication (HR 2.34, 95% CI 1.13-4.84) and mortality (HR 2.30, 95% CI 1.14- 4.65) compared with L-GNRI.

Conclusion: The GNRI shows strong potential as a simple and rapid tool for early risk stratification and prediction of adverse postoperative outcomes following rectal cancer surgery. Integrating nutritional assessment with validated biochemical markers may enhance prognostic evaluation in RC patients.

Disclosure of Interest: N. Russo: None declared, G. Porciello: None declared, A. Luongo: None declared, P. Rocco: None declared, F. Di Carlo: None declared, S. Coluccia: None declared, M. Grimaldi: None declared, F. Nocerino: None declared, M. D'Amico: None declared, L. Augustin Other: L.S.A. is a founding member of the International Carbohydrate Quality Consortium (ICQC) and has received honoraria from the Nutrition Foundation of Italy (NFI) and research grants from LILT, a non-profit organization for the fight against cancer. This study received in-kind research support from Abiogen Pharma, the Almond Board of California (USA), Barilla (Italy), Consorzio Mandorle di Avola (Italy), DietaDoc (Italy), Ello Frutta (Italy), Panificio Giacomo Luongo (Italy), Perrotta (Italy), Roberto Alimentare (Italy), and SunRice (Australia); however, these companies had no active role in either the project protocol or the study results. , G. D'Amico: None declared, A. Minopoli: None declared, E. Cavalcanti: None declared, L. Perna: None declared, U. Pace: None declared, F. Carbone: None declared, A. Luberto: None declared, P. Delrio: None declared, A. Crispo: None declared