PP375 - POSTOPERATIVE COMPLICATION RISK: ADIPOSE TISSUE AS A NOVEL BIOMARKER IN COLORECTAR SURGERY

PP375

POSTOPERATIVE COMPLICATION RISK: ADIPOSE TISSUE AS A NOVEL BIOMARKER IN COLORECTAR SURGERY

F. Mucarzel Suarez-Arana^1,*, R. Fernandez Jimenez², F. X. Palmas Candia¹, V. Soria Utrilla³, P. Guirado Peláez², F. Sanchez Torralvo³, J. M. García Almeida², R. Burgos Pelaez¹, G. Olveira³

¹Nutritional Support Unit, Hospital Universiario Vall d'Hebron, Barcelona, ²Endocrinology and Nutrition Department, Hospital Virgen de la Victoria, ³Endocrinology and Nutrition Department, Hospital Regional de Málaga, Málaga, Spain

Rationale: Preoperative Body Composition(BC), assessed through opportunistic automated Computed Tomography (CT) analysis, may play a relevant role in identifying PostOperative Risk(POR). The objective is to establish BC cut-off points(CP) defining an unfavorable status associated with a higher risk of PostOperative Complications(POC) in patients with Colorectal Cancer(CRC) undergoing elective surgery.

Methods: Prospective multicenter study. Quantity and quality(in Hounsfield Units, HU) of compartments measured at L3 level were analyzed using FocusedOn-BC software: Lean Muscle Area(LMA), Subcutaneous Adipose Tissue(SAT), and Intermuscular Adipose Tissue(IMAT). Sex-adjusted binary logistic regression was used to identify predictors of 30-day POC(overall complications, length of hospital stay, and mortality). Exploratory ROC curves were performed to define risk CP.

Results: A total of 502 patients were included, mostly male (62.5%), with a mean age of 68 years. Overall, 31.7% developed POC. Lower POR was observed in women (OR=0.437; p<0.001). Among BC parameters, greater muscle quantity and quality, along with lower intramuscular fat infiltration, showed a protective effect. Conversely, higher subcutaneous adipose tissue density (i.e., less negative HU values) was associated with increased complication risk. From a model with moderate discriminative ability (AUC=0.68; p<0.001), a high-risk profile (>P75) was identified: low muscle mass (LMA <15.66% in men, <13% in women), low muscle density (<33.6 HU in men, <27.9 HU in women), and less dense subcutaneous adipose tissue (SATD >−89 HU in men and >−83 HU in women).

Conclusion: The inclusion of adipose tissue quality assessed by preoperative CT demonstrated a clinically relevant association with POC in CRC patients. The identified cut-off points enable early risk stratification, highlighting their potential as a complementary opportunistic tool in preoperative assessment.

Disclosure of Interest: None declared