PD690 - IMPACT OF PERIOPERATIVE WEIGHT LOSS, AGE-ADJUSTED COMORBIDITY ON OUTCOMES AFTER CURATIVE-INTENT GASTRIC CANCER SURGERY

PD690

IMPACT OF PERIOPERATIVE WEIGHT LOSS, AGE-ADJUSTED COMORBIDITY ON OUTCOMES AFTER CURATIVE-INTENT GASTRIC CANCER SURGERY

O. Abdel-Lah Fernández^1,2,*, M. Torres Jurado², B. Chacón Cordero^1,3, C. Ruiz-Gorjón⁴, L. Cosido^1,2, J. Nieto², M. Borrego², F. Parreño^1,2, P. I. Dorado-Díaz¹

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

Rationale: Preoperative weight loss%PWL is a marker of nutritional impairment, Its independent prognostic value is uncertain. We evaluated the impact of %PWL, age-adjusted Charlson Comorbidity Index ACCI, and in-hospital weight loss %IHWL on postoperative outcomes.

Methods: Retrospective analysis,158 patients undergoing curative-intent gastric surgery. %PWL was % of weight loss 3–6months prior surgery. %IHWL was %weight loss from admission to discharge. Multivariable logistic and Cox regression models were constructed using an adjustment set including age, sex, ACCI, tumour stage, tumour location, neoadjuvant and %PWL. 30-day evaluation of impact of severe complications(CD ≥ III) on long-term outcomes.

Results: Follow-up 67 deaths and 52 DFS events occurred. Complications CD ≥ III:36 (22.8%). Adjusted Cox models, ACCI (HR1.26;95%CI1.03–1.54;p=0.022) and %PWL (HR1.04 per 1%↑;95% CI1.00–1.07;p=0.049) independently predicted < overall survival (OS). For DFS ACCI remained independently associated (HR1.41;95% CI1.07–1.85; p=0.015), whereas %PWL showed no association. Neoadjuvant was associated with DFS (HR2.25; 95% CI1.06–4.78; p=0.036). CD≥III were not predicted by %PWL or ACCI; proximal tumour was independent predictor of CD≥III events (OR3.12; 95% CI1.14–8.54; p=0.027). In 30-day landmark analyses, severe complications were not associated with long-term OS(p=0.281) or DFS(p=0.305). Complications CD ≥III were independently associated with ↑%IHWL, %IHWL predicted reintervention within 90 days (OR1.34 per 1% ↑;95% CI1.12–1.60; p<0.001). Reintervention:15patients10.2%.

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Conclusion: %PWL and ACCI independently predict <OS. DFS is influenced by tumour stage, comorbidity and neoadjuvant. Severe complications do not independently influence long-term oncological outcomes but are associated with acute %IHWL and ↑reintervention underscoring the clinical relevance of postoperative metabolic deterioration.

Disclosure of Interest: None declared