P388 - PREOPERATIVE CACHEXIA AND CLINICAL OUTCOMES IN PATIENTS UNDERGOING HEPATOBILIARY AND PANCREATIC SURGERY

P388

PREOPERATIVE CACHEXIA AND CLINICAL OUTCOMES IN PATIENTS UNDERGOING HEPATOBILIARY AND PANCREATIC SURGERY

Y. Fugane^1,*, S. Tanaka¹, Y. Yokoyama²

¹Department of Rehabilitation, ²Division of Surgical Oncology, Department of Surgery, Nagoya University Hospital, Nagoya , Japan

Rationale: Limited data exist regarding association between cachexia status and clinical outcomes in the hepatobiliary and pancreatic fields. This study sought to investigate the prognostic significance of preoperative cachexia in patients undergoing major hepatobiliary and pancreatic operations.

Methods: This retrospective cohort study was performed in patients undergoing major hepatobiliary and pancreatic surgeries for malignancy at a university hospital between March 2014 and December 2018. Cachexia was evaluated a few days before surgery, and defined as low body mass index and decreased handgrip strength or elevated C-reactive protein levels in accordance with the Asian Working Group for Cachexia criteria. The primary and secondary endpoints were postoperative overall survival (OS) and disease-free survival (DFS).

Results: A total of 354 patients (mean age: 68.6±10.2 years, 246 men) included in the study were divided into the non-cachexia group (n=259, 73%) and cachexia group (n=95, 27%). There were no significant differences in postoperative complications or length of hospital stay between the groups. After adjusting for covariates, the cachexia group showed significant associations with shorter OS (adjusted hazard ratio [HR] 1.65; P=0.003) and DFS (adjusted HR 1.38; P=0.043) compared to the non-cachexia group. In subgroup analysis, cachexia was significantly associated with shorter OS in patients with pathological stage ≤II (adjusted HR 2.43; P=0.008), but not in patients with pathological stage ≥III.

Conclusion: The presence of preoperative cachexia had an adverse effect on postoperative prognosis in patients undergoing major hepatobiliary and pancreatic surgeries for malignancy.

Disclosure of Interest: None declared