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PP075-MON DIET ENERGY DENSITY IS POSITIVELY ASSOCIATED WITH ENERGY INTAKE IN PALLIATIVE CARE CANCER PATIENTS
Nutrition and cancer III aged 57 vs 56; BMI 27±5.5 vs 27±3.5 kg/m2 . The mean percentage of weight loss at diagnosis was also similar 5.6 vs 5.5%. Patients with the feeding jejunostomy placed at surgery lost significantly (p < 0.05) less weight than patients with oral nutrition support throughout the oncology treatment (1, 3 and 6 months follow-up). Patients with the feeding jejunostomy remained with enteral nutrition support for 5.1±2.25 months. Conclusion: The implementation of feeding jejunostomy at the time of surgery for oesophageal cancer could improve or maintain nutritional status in patients with adjuvant therapy. Disclosure of Interest: None Declared
PP074-MON REDUCED QUALITY OF LIFE, EXERCISE CAPACITY AND SURVIVAL IN PALLIATIVE CARE CANCER PATIENTS WITH CACHEXIA O. Wallengren1 , K. Lundholm2 , I. Bosaeus1 . 1 Dept. Clinical nutrition, 2 Dept. Surgery, University of Gothenburg, Gothenburg, Sweden Rationale: Cachexia is associated with reduced quality of life (QoL), physical function, dietary intake and survival. There is limited information on the impact of diagnostic criteria of cachexia on these patient centred outcomes. We compared these outcomes in palliative care cancer patient with or without cachexia. Methods: Cachexia was defined as weight loss 5% and 2 of the following criteria: Low muscle strength (handgrip), lean tissue depletion (DXA or arm muscle circumference), abnormal biochemistry (inflammation, anemia or low serum albumin). QoL was assessed with generic and cancer specific questionnaires (SF-36 and EORTC QLQC30). Dietary intake was obtained from a 4-day food record. Exercise capacity was measured on a treadmill. Results: 432 patients were included. 211 (49%) were cachectic. Cachectic patients generally had lower QoL. Largest effect sizes (ES) were found for global QoL, vitality, physical functioning and social functioning (ES 0.59, 0.63, 0.54 and 0.51, all p < 0.001). Fatigue, loss of appetite and nausea/vomiting were higher (ES 0.63, 0.64 and 0.54, all p < 0.001). Exercise capacity, 25 watt ( 28%, p < 0.001), walking distance, 61 m ( 24%, p < 0.001), and energy intake, 161 kcal ( 9%, p = 0.02) were lower. Median survival was shorter in cachectic patients (133 vs. 216 days, p < 0.001). Conclusion: These criteria for cachexia diagnosis can identify patients likely to have reductions in QoL and clinically important reductions in physical function and survival. Implementation of cachexia assessment in clincal management of cancer patients may enable early initiation of multimodal treatment targeting symptoms of importance for QoL and function. Disclosure of Interest: None Declared
143 PP075-MON DIET ENERGY DENSITY IS POSITIVELY ASSOCIATED WITH ENERGY INTAKE IN PALLIATIVE CARE CANCER PATIENTS O. Wallengren1 , K. Lundholm2 , I. Bosaeus1 . 1 Dept. Clinical nutrition, 2 Dept. Surgery, University of Gothenburg, Gothenburg, Sweden Rationale: Diet energy density is associated with energy intake in cancer patients. There is limited information on the influence of patient characteristics on this association, potentially hampering individual tailoring of dietary treatment in clinical practice. Methods: We studied the relation between energy density (ED, kcal/g) and energy intake (EI, kcal/kg body weight), using a mixed linear model estimating both overall and individual intercept and slopes with patient characteristics as covariates. Age, sex, BMI, tumour type, tertiles of survival, weight loss, hypermetabolism, low muscle mass, low serum albumin, inflammation, handgrip strength and fatigue were entered in the model, and significant effects were retained (p < 0.05). Dietary intake was obtained from 252 food records (999 days) in a group of unselected palliative care cancer patients. ED and EI were calculated for each day including all food and beverages. Results: Mean energy intake was 25.8 kcal/kg. Age, BMI, fatigue and survival were negatively associated with EI. Effect estimates (1 SD) were: 1.5 kcal/kg for age, 3.7 kcal/kg for BMI and 1.0 kcal/kg for fatigue. For tertiles of survival, the effect was 4.0 kcal/kg for 1st and 2.7 kcal/kg for 2nd . After adjustment, energy density was still positively associated with EI with an overall effect of 4.7 kcal/kg per 1 SD. Conclusion: Age, BMI, fatigue and survival are associated with energy intake, but do not substantially influence the association between ED and EI in palliative care cancer patients. Disclosure of Interest: None Declared
PP076-MON INFLUENCE OF TWO TYPES OF LIPID EMULSIONS ON THE LIVER FUNCTIONAL STATUS OF PATIENTS WITH COLORECTAL LIVER METASTASIS RECEIVING CHEMOTHERAPY. A PROSPECTIVE RANDOMIZED STUDY O. Obukhova1 , V. Baykova1 , I. Kurmukov1 , S. Kashiya1 , I. Tikhonova1 . 1 Medical ICU, N.N.Blokhin Russian Cancer Research Center, Moscow, Russian Federation Rationale: Conducting antitumor chemotherapy accompanied by the increasing of protein-energetic insufficiency as a consequence of obligate amplification catabolic processes (cytotoxic effect of chemotherapy) and development of gastrointestinal toxicity (GT), which requires total parenteral nutrition (TPN). The aim of this study is to assess the effects of PN-mixtures “all in one” with different lipid emulsions (LE) on hepatic integrity. Methods: Forty patients (M:F = 18:22, mean age 56) with colorectal liver metastasis receiving chemotherapy (Oxaliplatin, Capecitabine) who developed Stage III-IV of GT in the course of the treatment were recruited and were randomized into 2 groups. The patients of group 1
PP074-MON REDUCED QUALITY OF LIFE, EXERCISE CAPACITY AND SURVIVAL IN PALLIATIVE CARE CANCER PATIENTS WITH CACHEXIA O. Wallengren1 , K. Lundholm2 , I. Bosaeus1 . 1 Dept. Clinical nutrition, 2 Dept. Surgery, University of Gothenburg, Gothenburg, Sweden Rationale: Cachexia is associated with reduced quality of life (QoL), physical function, dietary intake and survival. There is limited information on the impact of diagnostic criteria of cachexia on these patient centred outcomes. We compared these outcomes in palliative care cancer patient with or without cachexia. Methods: Cachexia was defined as weight loss 5% and 2 of the following criteria: Low muscle strength (handgrip), lean tissue depletion (DXA or arm muscle circumference), abnormal biochemistry (inflammation, anemia or low serum albumin). QoL was assessed with generic and cancer specific questionnaires (SF-36 and EORTC QLQC30). Dietary intake was obtained from a 4-day food record. Exercise capacity was measured on a treadmill. Results: 432 patients were included. 211 (49%) were cachectic. Cachectic patients generally had lower QoL. Largest effect sizes (ES) were found for global QoL, vitality, physical functioning and social functioning (ES 0.59, 0.63, 0.54 and 0.51, all p < 0.001). Fatigue, loss of appetite and nausea/vomiting were higher (ES 0.63, 0.64 and 0.54, all p < 0.001). Exercise capacity, 25 watt ( 28%, p < 0.001), walking distance, 61 m ( 24%, p < 0.001), and energy intake, 161 kcal ( 9%, p = 0.02) were lower. Median survival was shorter in cachectic patients (133 vs. 216 days, p < 0.001). Conclusion: These criteria for cachexia diagnosis can identify patients likely to have reductions in QoL and clinically important reductions in physical function and survival. Implementation of cachexia assessment in clincal management of cancer patients may enable early initiation of multimodal treatment targeting symptoms of importance for QoL and function. Disclosure of Interest: None Declared
143 PP075-MON DIET ENERGY DENSITY IS POSITIVELY ASSOCIATED WITH ENERGY INTAKE IN PALLIATIVE CARE CANCER PATIENTS O. Wallengren1 , K. Lundholm2 , I. Bosaeus1 . 1 Dept. Clinical nutrition, 2 Dept. Surgery, University of Gothenburg, Gothenburg, Sweden Rationale: Diet energy density is associated with energy intake in cancer patients. There is limited information on the influence of patient characteristics on this association, potentially hampering individual tailoring of dietary treatment in clinical practice. Methods: We studied the relation between energy density (ED, kcal/g) and energy intake (EI, kcal/kg body weight), using a mixed linear model estimating both overall and individual intercept and slopes with patient characteristics as covariates. Age, sex, BMI, tumour type, tertiles of survival, weight loss, hypermetabolism, low muscle mass, low serum albumin, inflammation, handgrip strength and fatigue were entered in the model, and significant effects were retained (p < 0.05). Dietary intake was obtained from 252 food records (999 days) in a group of unselected palliative care cancer patients. ED and EI were calculated for each day including all food and beverages. Results: Mean energy intake was 25.8 kcal/kg. Age, BMI, fatigue and survival were negatively associated with EI. Effect estimates (1 SD) were: 1.5 kcal/kg for age, 3.7 kcal/kg for BMI and 1.0 kcal/kg for fatigue. For tertiles of survival, the effect was 4.0 kcal/kg for 1st and 2.7 kcal/kg for 2nd . After adjustment, energy density was still positively associated with EI with an overall effect of 4.7 kcal/kg per 1 SD. Conclusion: Age, BMI, fatigue and survival are associated with energy intake, but do not substantially influence the association between ED and EI in palliative care cancer patients. Disclosure of Interest: None Declared
PP076-MON INFLUENCE OF TWO TYPES OF LIPID EMULSIONS ON THE LIVER FUNCTIONAL STATUS OF PATIENTS WITH COLORECTAL LIVER METASTASIS RECEIVING CHEMOTHERAPY. A PROSPECTIVE RANDOMIZED STUDY O. Obukhova1 , V. Baykova1 , I. Kurmukov1 , S. Kashiya1 , I. Tikhonova1 . 1 Medical ICU, N.N.Blokhin Russian Cancer Research Center, Moscow, Russian Federation Rationale: Conducting antitumor chemotherapy accompanied by the increasing of protein-energetic insufficiency as a consequence of obligate amplification catabolic processes (cytotoxic effect of chemotherapy) and development of gastrointestinal toxicity (GT), which requires total parenteral nutrition (TPN). The aim of this study is to assess the effects of PN-mixtures “all in one” with different lipid emulsions (LE) on hepatic integrity. Methods: Forty patients (M:F = 18:22, mean age 56) with colorectal liver metastasis receiving chemotherapy (Oxaliplatin, Capecitabine) who developed Stage III-IV of GT in the course of the treatment were recruited and were randomized into 2 groups. The patients of group 1