PD1032 - THE MODIFIED GLASGOW PROGNOSTIC SCORE AS A PREDICTOR OF IN-HOSPITAL WEIGHT LOSS AND SURVIVAL IN PATIENTS UNDERGOING CURATIVE-INTENT GASTRIC CANCER RESECTION.

PD1032

THE MODIFIED GLASGOW PROGNOSTIC SCORE AS A PREDICTOR OF IN-HOSPITAL WEIGHT LOSS AND SURVIVAL IN PATIENTS UNDERGOING CURATIVE-INTENT GASTRIC CANCER RESECTION.

O. Abdel-Lah Fernández^1,2,*, M. Torres Jurado¹, B. Chacón Cordero^2,3, C. Ruiz-Gorjón⁴, L. Cosido^1,2, J. Nieto¹, M. Borrego¹, F. Parreño^1,2, P. I. Dorado-Díaz²

¹Surgery, Complejo Asistencial Universitario de Salamanca, ²Universidad de Salamanca, Salamanca, Spain, ³Universidad de Costa Rica, San Jose, Costa Rica, ⁴Primary care, SACYL, Salamanca, Spain

Rationale: Preoperative nutritional/inflammatory status are determinants of outcomes in surgical oncology. The prognostic value of systemic inflammation, specifically mGPS, remains unclear when adjusted for comorbidities and tumor stage. This study aimed to evaluate the influence of mGPS on perioperative outcome.

Methods: Retrospective analysis of 158 patients undergoing curative-intent gastric cancer surgery. mGPS was calculated from preoperative CRP and albumin. Multivariable Cox and logistic regression models included age, sex, mGPS, NRS-2002 (≥3 vs <3), and tumour stage. To assess the independent contribution of mGPS beyond NRS, models were run with and without NRS. In-hospital weight loss (%IHWL) was modelled by linear regression. 

Results: Severe postoperative complications [CD] ≥III occurred in 22.8%. mGPS was not an independent predictor of severe morbidity (OR 1.12; p=0.685). Regarding long-term outcomes, mGPS was significantly associated with Overall Survival (OS) in univariate analysis (p=0.032), this effect was attenuated after multivariable adjustment (HR1.26;p=0.162), indicating confounding by stage and ACCI.

 In the locally advanced subgroup n=100, mGPS emerged as an independent predictor of DFS (HR1.52;95% CI1.01–2.29;p=0.043), suggesting that inflammation plays a more critical role in tumor dynamics in advanced stages. Critically, mGPS was a robust independent predictor of perioperative catabolism (%IHWL) (β=+1.30 per point;p=0.027), identifying patients at higher risk for acute nutritional depletion

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Conclusion: mGPS is a powerful tool to identify patients at risk of accelerated perioperative catabolism, regardless of their baseline weight loss or comorbidities. While its impact on OS is secondary to tumor stage and comorbidity, mGPS serves as an independent prognostic factor for recurrence in locally advanced disease.

Disclosure of Interest: None declared