eP479 - Association of Tumor Grading and Nutritional Status Among Colorectal Cancer Patients in a Tertiary Private Hospital

Purpose/Background: Malnutrition is a frequent hallmark of cancer patients, causing negative impact on clinical outcomes and mortality. In particular, colorectal cancer patients are at risk for malnutrition with a prevalence of about 35% among pre-operative patients. Well established factors that demonstrate link between malnutrition and cancer include tumor stage, type or location of tumor, and treatment type and setting. Tumor grade is a significant determinant of tumor prognosis and thus, management of cancer patients as well. However, the potential association between tumor grade and nutritional status of oncologic lesions has not been well characterized. This cross-sectional study evaluated the association of tumor grade on the nutritional status of patients diagnosed with colorectal malignancy at St Luke’s Medical Center Quezon City between January 2019 to December 2022.Methods/Interventions: This is a retrospective, cross sectional analytical study among adult patients with malnutrition and its association with the tumor grade of colorectal cancer. This study employed the use of Subjective Global Assessment (SGA) criteria to assess patients in terms of nutritional status.Results/Outcomes: A total of 196 patients were included in the study of which, 49.49% had moderate malnutrition while 48.98% had severe malnutrition with varying clinicodemographic profiles. In terms of histologic grade, the distribution of well-differentiated, moderately differentiated, poorly differentiated, and undifferentiated tumors were as follows:16 (8.16%); 166 (84.69%); 14 (7.14%); 0 (0%). There is no statistically significant association between histologic grade and nutritional status defined using the SGA (P=0.249) criteria. In the multivariate regression analysis, BMI was independently associated with severe malnutrition (P=0.008). However, holding all other variables constant, histologic grade was not an independent predictor of severe malnutrition (P=0.521).Conclusion/

Discussion: The data presented in the study showed high prevalence of severe malnutrition among patients with colorectal cancer. In particular, patients with colorectal cancer compared with other types of cancer have been found to have one of the highest rates of malnutrition due to its local effects on bowel function from obstruction and malabsorption. Malnutrition among cancer patients is associated with increased risk of complications, reduced physical functioning, impaired quality of life, and decreased survival. Result of our study showed that there is no statistically significant association between histologic grade and nutritional status defined using the SGA. Other relevant data on this issue in the literature are rather scarce. Being underweight was a significant predictor for severe malnutrition in the multivariate regression analysis. BMI has a well-validated outcome predictive value. It is widely accepted as one of criteria for diagnosing and stratifying severity of malnutrition such as in GLIM criteria, NRS 2002 and cancer cachexia.Regardless of histologic grade of colorectal cancer, nutritional assessment should be carried out to identify those at risk of severe malnutrition and the need for early nutritional supplementation and intervention. Larger multicenter prospective studies, however, are recommended.