ESPEN 2020 Abstract Submission

Topic: Nutrition and cancer

Abstract Submission Identifier: ESPEN20-ABS-1215

IMPACT OF PREOPERATIVE VISCERAL FAT MASS ON SHORT AND LONG-TERM OUTCOMES OF GASTRECTOMY FOR ADVANCED GASTRIC CANCER PATIENTS

R. Matsui^*, ¹, N. Inaki ¹, T. Tsuji ², S. Kadoya ², M. Ouchi ¹, J. Yoshimoto ¹, K. Nagakari ¹, Y. Ishizaki ¹

¹Department of digestive and general surgery, JUNTENDO UNIVERSITY URAYASU HOSPITAL, Urayasu, ²Department of gastroenterological surgery, Ishikawa prefectural central hospital, Kanazawa, Japan

Rationale: It has been reported that a high visceral fat mass is associated with increased postoperative infection in radical gastrectomy for gastric cancer. These severe complications result in a poor prognosis. However, the impact of visceral fat mass on prognosis remains unknown. In this study, we investigated the impact on visceral fat mass on short and long-term postoperative outcomes in radical gastrectomy for gastric cancer.

Methods: Four hundred eighty-five patients who were diagnosed with advanced gastric cancer over clinical stage IB and underwent radical gastrectomy from April 2008 to December 2018 were investigated. Visceral fat mass was preoperatively calculated by the index measuring the cross-sectional area of the umbilical level on computed tomography and dividing by the square of the height (visceral fat mass index [VFI] ). The cut-off value for VFI was calculated by drawing the ROC curve in the point of the relationship with postoperative complications. Regarding short-term outcomes, we performed univariate and multivariate analyses using logistic regression analysis for severe and infectious complications (Clavien-Dindo classification 3 or higher). For the long-term outcomes, univariate and multivariate analyses were performed on the relationship of prognosis using Cox proportional hazards regression analysis.

Results: Two hundred and seventy patients (55.6%) were classified in the high VFI group. The cutoff value for VFI was calculated as 30.56 cm²/m² for men and 24.32 cm²/m² for women.In multivariate analysis using logistic regression, high VFI was an independent risk factor for severe complications (OR 2.18, 95％ CI 1.13-4.21，P＝0.020) and infectious complications (OR 2.10, 95% CI 1.12-3.91, P＝0.020).In multivariate analysis using Cox proportional hazards regression analysis, high VFI was an independent prognostic factor (OR 0.26, 95% CI 0.07-0.94, P = 0.039).

Conclusion: Although preoperative high VFI was a factor that increased postoperative infection, it was also a factor that improved overall survival after radical gastrectomy. This suggests the importance of proper perioperative nutrition management.

Disclosure of Interest: None Declared

Keywords: gastric cancer, VISCERAL FAT