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PP088-SUN: Evaluation of Hypothalamic Activity in Cancer Anorexia by Functional Magnetic Resonance
S52
Poster presentations
demonstrated no change in fat oxidation, but carbohydrate oxidation (p = 0.0137) and non-oxidative glucose disposal (p = 0.02) decreased in all patients. The clamp demonstrated reduced insulin sensitivity (IS, p = 0.036). Table 1.
DXA Fat mass (Mean±SD), kg Lean mass (Mean±SD), kg CT Fat mass (Mean±SD), kg Fat-free mass (Mean±SD), kg
Before NAC
After NAC
p-value
22.5±7.4 51.8±6.2
21.1±7.7 52.0±5.7
0.62 0.26
26.3±9.4 57.2±8.0
25.5±9.7 53.6±6.8
0.60 0.02
Conclusion: Sarcopenia was widely prevalent in OGC patients despite normal or high BMI. NAC was associated with reduced fat free mass & IS which may be of clinical significance. Although INSP did not affect measured outcomes in this study, it warrants further investigation. Disclosure of Interest: N. Tewari Grant/Research Support from: CORE (Digestive Disorders Foundation, UK), S. Awad Grant/Research Support from: CORE (Digestive Disorders Foundation, UK) and ESPEN Research Network Grant 2011/2012, J. Catton: None Declared, S. Madhusudan: None Declared, I. Macdonald: None Declared, D. Lobo: None Declared.
PP088-SUN EVALUATION OF HYPOTHALAMIC ACTIVITY IN CANCER ANOREXIA BY FUNCTIONAL MAGNETIC RESONANCE A. Molfino1, C. Colaiacomo2 , G. Gualdi2 , A. Ianance3 , P. Seminara3 , M. Muscaritoli1 , A. Laviano1 , F. Rossi Fanelli1 . 1 Clinical Medicine, 2 Radiology, 3 Oncology, Sapienza University of Rome, Rome, Italy Rationale: To determine the specific pattern(s) of the brain activation in anorexic (A) and non-anorexic (NA) lung cancer patients to reveal potential differences by the use of functional magnetic resonance (fMRI). Methods: Anorexia was investigated using a questionnaire. Hypothalamic activation by fMRI before and after administration of an oral nutritional supplement was evaluated. The average value of the grey for the hypothalamus was calculated, and normalized respect to basal condition. Data were statistically analyzed using the t-Student and Bonferroni tests. Results: Seven patients were A, 4 NA, as revealed by the questionnaire. Anorexic patients presented a lower hypothalamic activity respect to NA in basal condition (% of signal intensity change) (573±46 vs 669±27, p = 0.004, respectively), immediately after the standard meal assumption (520.6±60 vs 610.5±25.6, p = 0.02, respectively) and after 15 minutes from meal assumption (543.4±49.1 vs 623.4±60.5, p = 0.039, respectively). Only NA patients significantly reduced the hypothalamic signals from basal condition to the period immediately after the meal assumption (669.3±27.2 vs 610.5±25.6, p = 0.01, respectively). Conclusion: Hypothalamic activity is depressed and does not respond to oral challenges. We speculate that the gut brain axis is impaired in anorexic cancer patients. Our study confirms the diagnostic accuracy of the anorexia questionnaire and the reliability of fMRI in studying brain activity in vivo. Acknowledgement: This project was supported by the Italian Society of Internal Medicine (SIMI). A.M. received a grant funded by Umberto Veronesi Foundation. Disclosure of Interest: None Declared.
PP089-SUN ASSESSMENT OF NUTRITIONAL STATUS AND THE INVESTIGATION OF ITS CONNECTION WITH OPERABILITY AND HYPERTROPHY IN CASE OF PORTAL OCCLUSION PROCEDURE ON LIVER TUMOR PATIENTS ´. T¨ as2 , A. Zsirka-Klein1 , E or¨ ok1 , O. Hahn1 , P. Pajor1 , I. Dud´ 1 1 1 P. Kupcsulik , L. Hars´ anyi . 1st Department of Surgery, 2 Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary Introduction: In most cases of liver tumor resection is the only method offering long term survival. If the future liver remnant (FLR) is not enough then portal vein occlusion techniques are needed to hypertrophise the FLR. Objectives: Our aim is to assess the body composition of these patients, to affect these parameters by nutritional supplementation and to investigate the effects of supplemetation on operability, the hypertrophy of FLR and on tumor volume. Patient population and Methods: 54 patients were included in the study. Body composition was assessed. Patients with healthy liver tissue were divided into two gorups. The “arginin” group received increased protein and arginin supplementation, while the “protein” group increased protein supplementation only. After portal occlusion patients received 2×200 ml supplementation during hypertrophy. The HCC group received no supplementation. After the hypertrophy period FLR%, tumor volume and body compositions were reassessed. Results: FLR% and tumor volume change were tendentious, FLR%: “arg.” 13.51% vs. “prot.” 10.64% vs. HCC 8.81%, tumor volume: “arg.” 5.23 cm2 vs. “prot.” 69.65 cm2 HCC 135.14 cm2 . Changes in body composition parameters were significantly better in “arginin” than in the “protein” group: lean tissue mass change: “arg.” 1.05 vs. “prot.” 0.69 vs. HCC 3.56 kg, p < 0.05. Results of the operable vs. inoperable patients showed significant difference in body composition, fat mass%: operable 28.59% vs. inoperable 35.3%, lean tissue mass%: operable 69.64% vs. inoperable 58.54%, body cell mass%: operable 41.95% vs. inoperable 35.62%, p < 0.05. Body weight of the operable vs. inoperable patients showed no significant difference. Conclusion: Assessment of nutritional status before portal vein occlusion is important therefore its correction is necessary. Disclosure of Interest: None Declared.
Poster presentations
demonstrated no change in fat oxidation, but carbohydrate oxidation (p = 0.0137) and non-oxidative glucose disposal (p = 0.02) decreased in all patients. The clamp demonstrated reduced insulin sensitivity (IS, p = 0.036). Table 1.
DXA Fat mass (Mean±SD), kg Lean mass (Mean±SD), kg CT Fat mass (Mean±SD), kg Fat-free mass (Mean±SD), kg
Before NAC
After NAC
p-value
22.5±7.4 51.8±6.2
21.1±7.7 52.0±5.7
0.62 0.26
26.3±9.4 57.2±8.0
25.5±9.7 53.6±6.8
0.60 0.02
Conclusion: Sarcopenia was widely prevalent in OGC patients despite normal or high BMI. NAC was associated with reduced fat free mass & IS which may be of clinical significance. Although INSP did not affect measured outcomes in this study, it warrants further investigation. Disclosure of Interest: N. Tewari Grant/Research Support from: CORE (Digestive Disorders Foundation, UK), S. Awad Grant/Research Support from: CORE (Digestive Disorders Foundation, UK) and ESPEN Research Network Grant 2011/2012, J. Catton: None Declared, S. Madhusudan: None Declared, I. Macdonald: None Declared, D. Lobo: None Declared.
PP088-SUN EVALUATION OF HYPOTHALAMIC ACTIVITY IN CANCER ANOREXIA BY FUNCTIONAL MAGNETIC RESONANCE A. Molfino1, C. Colaiacomo2 , G. Gualdi2 , A. Ianance3 , P. Seminara3 , M. Muscaritoli1 , A. Laviano1 , F. Rossi Fanelli1 . 1 Clinical Medicine, 2 Radiology, 3 Oncology, Sapienza University of Rome, Rome, Italy Rationale: To determine the specific pattern(s) of the brain activation in anorexic (A) and non-anorexic (NA) lung cancer patients to reveal potential differences by the use of functional magnetic resonance (fMRI). Methods: Anorexia was investigated using a questionnaire. Hypothalamic activation by fMRI before and after administration of an oral nutritional supplement was evaluated. The average value of the grey for the hypothalamus was calculated, and normalized respect to basal condition. Data were statistically analyzed using the t-Student and Bonferroni tests. Results: Seven patients were A, 4 NA, as revealed by the questionnaire. Anorexic patients presented a lower hypothalamic activity respect to NA in basal condition (% of signal intensity change) (573±46 vs 669±27, p = 0.004, respectively), immediately after the standard meal assumption (520.6±60 vs 610.5±25.6, p = 0.02, respectively) and after 15 minutes from meal assumption (543.4±49.1 vs 623.4±60.5, p = 0.039, respectively). Only NA patients significantly reduced the hypothalamic signals from basal condition to the period immediately after the meal assumption (669.3±27.2 vs 610.5±25.6, p = 0.01, respectively). Conclusion: Hypothalamic activity is depressed and does not respond to oral challenges. We speculate that the gut brain axis is impaired in anorexic cancer patients. Our study confirms the diagnostic accuracy of the anorexia questionnaire and the reliability of fMRI in studying brain activity in vivo. Acknowledgement: This project was supported by the Italian Society of Internal Medicine (SIMI). A.M. received a grant funded by Umberto Veronesi Foundation. Disclosure of Interest: None Declared.
PP089-SUN ASSESSMENT OF NUTRITIONAL STATUS AND THE INVESTIGATION OF ITS CONNECTION WITH OPERABILITY AND HYPERTROPHY IN CASE OF PORTAL OCCLUSION PROCEDURE ON LIVER TUMOR PATIENTS ´. T¨ as2 , A. Zsirka-Klein1 , E or¨ ok1 , O. Hahn1 , P. Pajor1 , I. Dud´ 1 1 1 P. Kupcsulik , L. Hars´ anyi . 1st Department of Surgery, 2 Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary Introduction: In most cases of liver tumor resection is the only method offering long term survival. If the future liver remnant (FLR) is not enough then portal vein occlusion techniques are needed to hypertrophise the FLR. Objectives: Our aim is to assess the body composition of these patients, to affect these parameters by nutritional supplementation and to investigate the effects of supplemetation on operability, the hypertrophy of FLR and on tumor volume. Patient population and Methods: 54 patients were included in the study. Body composition was assessed. Patients with healthy liver tissue were divided into two gorups. The “arginin” group received increased protein and arginin supplementation, while the “protein” group increased protein supplementation only. After portal occlusion patients received 2×200 ml supplementation during hypertrophy. The HCC group received no supplementation. After the hypertrophy period FLR%, tumor volume and body compositions were reassessed. Results: FLR% and tumor volume change were tendentious, FLR%: “arg.” 13.51% vs. “prot.” 10.64% vs. HCC 8.81%, tumor volume: “arg.” 5.23 cm2 vs. “prot.” 69.65 cm2 HCC 135.14 cm2 . Changes in body composition parameters were significantly better in “arginin” than in the “protein” group: lean tissue mass change: “arg.” 1.05 vs. “prot.” 0.69 vs. HCC 3.56 kg, p < 0.05. Results of the operable vs. inoperable patients showed significant difference in body composition, fat mass%: operable 28.59% vs. inoperable 35.3%, lean tissue mass%: operable 69.64% vs. inoperable 58.54%, body cell mass%: operable 41.95% vs. inoperable 35.62%, p < 0.05. Body weight of the operable vs. inoperable patients showed no significant difference. Conclusion: Assessment of nutritional status before portal vein occlusion is important therefore its correction is necessary. Disclosure of Interest: None Declared.