LB110 - NUTRITIONAL, FUNCTIONAL, METABOLIC AND INFLAMMATORY CHANGES IN PREOPERATIVE PATIENTS WITH COLORECTAL CANCER UNDERGOING PREHABILITATION

LB110

NUTRITIONAL, FUNCTIONAL, METABOLIC AND INFLAMMATORY CHANGES IN PREOPERATIVE PATIENTS WITH COLORECTAL CANCER UNDERGOING PREHABILITATION

E. FERREIRA^1,2,*, F. D. S. B. BRITO³, A. SCHTSCHERBYNA¹, E. FIALHO¹

¹Nutrition Institute Josué de Castro, Federal University of Rio de Janeiro, ²Army Central Hospital, ³Nutrition Institute , Rio de Janeiro State University, Rio de Janeiro, Brazil

Rationale: Patients with CRC often present nutritional impairment, systemic inflammation, and metabolic alterations before surgery, which may adversely affect surgical outcomes. However, longitudinal changes during prehabilitation remain poorly understood.

Methods: This prospective observational cohort study included 49 adults with CRC undergoing elective surgery within a prehabilitation program at a military hospital in Rio de Janeiro, Brazil. Assessments were performed at baseline and preoperatively to evaluate nutritional, functional, metabolic, and inflammatory parameters. Anthropometric data included BMI, waist, calf and arm circumferences, and handgrip strength. Nutritional status was assessed using GLIM and PG-SGA. Physical activity and bowel habits were evaluated using the International Physical Activity Questionnaire and Bristol Stool Scale. Biochemical assessment included glucose, insulin, HOMA-IR, NLR, PNI, vitamins D and B12.

Results: No significant changes were observed in BMI. However, significant improvements were observed in arm circumference (p=0.025), calf circumference (p=0.008), arm muscle circumference (p<0.001), handgrip strength (p<0.001), PG-SGA (p<0.001) and GLIM (p=0.003). Physical activity level increased significantly (p<0.001), accompanied by improved bowel habits (p<0.001). Metabolic and inflammatory markers also improved, including fasting glucose (p=0.023), insulin, HOMA-IR and PNI (p<0.001). Elevated NLR decreased significantly (p=0.002), while vitamins D (p=0.004) and B12 (p<0.001) increased significantly.

Conclusion: Prehabilitation improved nutritional, functional and metabolic parameters in patients with CRC undergoing elective surgery, supporting its role in preoperative optimization and perioperative care.

References: Weimann A, et al. ESPEN guideline on clinical nutrition in surgery – Update 2025. Clinical Nutrition. 2025;53:222-261.

Disclosure of Interest: None declared