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SUN-P078: Determination of Malnutrition and Sarcopenia in Geriatric Patients with Gastrointestinal Malignancy
Nutrition and cancer 1 Rationale: This study reports nutritional intervention in 2015 in hospitalized cancer patients at Federico II University Hospital. Methods: Four hundred fifty five hospitalized cancer patients who needed nutritional therapy were retrospectively evaluated. All cancer patients were affected by active oncologic disease and candidates to surgical treatment (n = 208) or chemotherapy/radiotherapy (n = 220) or bone marrow transplantation (n = 27). Tumor types were grouped as: head-neck cancer (HNC), gastrointestinal cancer (GIC), blood cancer (BC), other cancers (OC) as lung, skin, breast, prostate, uterus, renal, etc. The nutritional prescription was personalized according to the degree of malnutrition, site and stage of the disease, type of antineoplastic therapy, and included: parenteral nutrition (P), enteral tube feeding (E), oral nutritional supplements (ONS) and mixed (M) nutrition. Results: Among nutritionally supported cancer patients (aged 17–92 y, mean = 65 y; 269 male/186 female) prevalence rates for cancer types were: HNC = 18%, GIC = 57%, BC = 9%, OC = 16%. No significant sex difference was found in the frequency of cancer groups. Mean age (95% CI) for cancer group was: HNC = 63 y, (60–66 y); GIC = 67 y, (66–68 y); BC = 55 y, (50–60 y); OC = 63 y, (60–66 y). Median duration and type of nutritional therapy was 14 days for HNC: ( p = 7%, E = 57%, ONS = 11%, M = 25%); 10 days for GIC: ( p = 62%, E = 0%,%, M = 11%); 13 days for BC: ( p = 50%, E = 0%,%, M = 31%); 10 days for OC: ( p = 33%, E = 0%,%, M = 18%). Conclusion: Anorexia and cachexia are the most common causes of malnutrition in cancer patients in particular during therapeutic treatments. However, the early assessment of nutritional status and appropriate nutritional prescription by a well trained nutritional team could support these patients to better tolerate and complete the specific therapy, often avoiding early and counter-productive interruptions and reducing length of hospitalization. Disclosure of Interest: None declared
SUN-P078 DETERMINATION OF MALNUTRITION AND SARCOPENIA IN GERIATRIC PATIENTS WITH GASTROINTESTINAL MALIGNANCY D. Hopanci Bicakli1, A. Ozveren1, R. Uslu1, B. Karabulut1, R. Meseri Dalak2, R. Cehreli3, M. Uyar4, F. Akcicek5. 1Medical Oncology Department, Ege University Hospital, 2Nutrition and Dietetic Department, Ege University, 3Preventive Oncology Department, 9 Eylul University, 4Intensive Care Department, Ege University Hospital, 5Department of Geriatrics, Ege University, Izmir, Turkey Rationale: Malnutrition and sarcopenia are important problems especially in geriatric cancer patients. The aim of this study was to determine the incidence of malnutrition, sarcopenia and also the effect of a single cycle of chemotherapy (CT) on nutritional status of patients with gastrointestinal (GI) cancers. Methods: The study included patients who were ≥65 years old with GI cancer and received CT in a Oncology Center between December 2014–July 2015. All patients’ mini nutritional assessments (MNA), antropometric measurements; height, weight, calf (CC) and upper arm circumference (UAC) were carried out. Phase angle and muscle mass were measured by Tanita MC 780. Nutritional counselling was provided to all patients based on individual needs. Same parameters were
S73 measured after a single cycle of CT and the results were compared with the initial data. Results: 154 patients (mean age: 70.5 ± 5.6.44 female, 109 male) with GI cancer were followed up and evaluated. Colorectal (%51.6), stomach (26.8%), pancreas (11.8%), liver (7.2%), bile duct (2%) and esophagus cancers (%0.7) composed the diagnoses of the patients included in the study. Malnutrition rate after one cycle of CT in patients increased (37.9% to 46.4%, p = 0.001). CC measurement (34.8 ± 4.2 to 33.9 ± 4.2, p < 0.001), UAC (28.5 ± 4.4 to 28.1 ± 4.9,p = 0.034) and hand grip strength (27.5 ± 8.6, 26.8 ± 8.8,p = 0.007) were decreased after CT. Severe sarcopenia was detected in 39(%25) and moderate sarcopenia was detected in 88 (%57.5) patients. Phase angle measurements in patients with and without malnutrition were 4.56° and 5.09° respectively ( p < 0.001). Conclusion: Sarcopenia is a very common problem in patients with GI cancers. Even a single dose of CT was shown to cause worsening in nutritional status. In addition hand dynamometer and calf circumference measurement are easy methods that can be performed at every visit and may be used as simple evaluation methods for malnutrition and sarcopenia. Disclosure of Interest: None declared
SUN-P079 HOME PARENTERAL NUTRITION IN CANCER PATIENTS: TRAINED FAMILY CAREGIVER OR GENERAL HOME NURSE? C. Dalla Costa1, D. N. Sabet1, A. Bracco1, E. Conterno1, E. Lenta1, L. Neri1, G. Viglino1. 1Medicine, San Lazzaro Hospital, Alba, Italy Rationale: Purpose of this study is to prove the appropriateness of a dedicated family caregiver for the management of Home Parenteral Nutrition (HPN) in non-hospitalized cancer patients, particularly analyzing the incidence of Catheter Related Blood Stream Infections (CRBSIs) in patients managed by a trained family caregiver compared to patients managed by a general nursing team provided by the Regional Public Health Service. Methods: In 2011 we asked the contractors of HPN’s service for a specific in-home training to patient’s caregiver. This training had to be carried out by a specialized dedicated nurse, in a maximum of 5 days. After assessing caregiver’s knowledge and competency (recorded in an appropriate evaluation form), cancer patients could autonomously receive HPN. Results: Since May 2011 through February 2016, 127 nonhospitalized cancer patients met all the criteria for receiving HPN; 108 carried out the management with a family caregiver and 19 performed HPN with a general home nurse. The incidence rate of CRBSIs in the first group was 0.6 per 1,000 catheter days, in the second group was 3.1. Time to first CRBSI episode was significantly shorter in the nurse group (Log Rank Test p = 0.001). Multivariable Cox proportional hazards model was used to determine the independent effects of performer’s type in predicting CRBSI’s first episode: the relative risk was significantly lower in the family caregiver group (HR 0.11, 95% CI 0.024–0.510, p = 0.005). Conclusion: The literature reports that the self management of HPN, carried out by trained patient, performs better than nurse care in non-cancer patients (lower incidence of CRBSIs).
SUN-P078 DETERMINATION OF MALNUTRITION AND SARCOPENIA IN GERIATRIC PATIENTS WITH GASTROINTESTINAL MALIGNANCY D. Hopanci Bicakli1, A. Ozveren1, R. Uslu1, B. Karabulut1, R. Meseri Dalak2, R. Cehreli3, M. Uyar4, F. Akcicek5. 1Medical Oncology Department, Ege University Hospital, 2Nutrition and Dietetic Department, Ege University, 3Preventive Oncology Department, 9 Eylul University, 4Intensive Care Department, Ege University Hospital, 5Department of Geriatrics, Ege University, Izmir, Turkey Rationale: Malnutrition and sarcopenia are important problems especially in geriatric cancer patients. The aim of this study was to determine the incidence of malnutrition, sarcopenia and also the effect of a single cycle of chemotherapy (CT) on nutritional status of patients with gastrointestinal (GI) cancers. Methods: The study included patients who were ≥65 years old with GI cancer and received CT in a Oncology Center between December 2014–July 2015. All patients’ mini nutritional assessments (MNA), antropometric measurements; height, weight, calf (CC) and upper arm circumference (UAC) were carried out. Phase angle and muscle mass were measured by Tanita MC 780. Nutritional counselling was provided to all patients based on individual needs. Same parameters were
S73 measured after a single cycle of CT and the results were compared with the initial data. Results: 154 patients (mean age: 70.5 ± 5.6.44 female, 109 male) with GI cancer were followed up and evaluated. Colorectal (%51.6), stomach (26.8%), pancreas (11.8%), liver (7.2%), bile duct (2%) and esophagus cancers (%0.7) composed the diagnoses of the patients included in the study. Malnutrition rate after one cycle of CT in patients increased (37.9% to 46.4%, p = 0.001). CC measurement (34.8 ± 4.2 to 33.9 ± 4.2, p < 0.001), UAC (28.5 ± 4.4 to 28.1 ± 4.9,p = 0.034) and hand grip strength (27.5 ± 8.6, 26.8 ± 8.8,p = 0.007) were decreased after CT. Severe sarcopenia was detected in 39(%25) and moderate sarcopenia was detected in 88 (%57.5) patients. Phase angle measurements in patients with and without malnutrition were 4.56° and 5.09° respectively ( p < 0.001). Conclusion: Sarcopenia is a very common problem in patients with GI cancers. Even a single dose of CT was shown to cause worsening in nutritional status. In addition hand dynamometer and calf circumference measurement are easy methods that can be performed at every visit and may be used as simple evaluation methods for malnutrition and sarcopenia. Disclosure of Interest: None declared
SUN-P079 HOME PARENTERAL NUTRITION IN CANCER PATIENTS: TRAINED FAMILY CAREGIVER OR GENERAL HOME NURSE? C. Dalla Costa1, D. N. Sabet1, A. Bracco1, E. Conterno1, E. Lenta1, L. Neri1, G. Viglino1. 1Medicine, San Lazzaro Hospital, Alba, Italy Rationale: Purpose of this study is to prove the appropriateness of a dedicated family caregiver for the management of Home Parenteral Nutrition (HPN) in non-hospitalized cancer patients, particularly analyzing the incidence of Catheter Related Blood Stream Infections (CRBSIs) in patients managed by a trained family caregiver compared to patients managed by a general nursing team provided by the Regional Public Health Service. Methods: In 2011 we asked the contractors of HPN’s service for a specific in-home training to patient’s caregiver. This training had to be carried out by a specialized dedicated nurse, in a maximum of 5 days. After assessing caregiver’s knowledge and competency (recorded in an appropriate evaluation form), cancer patients could autonomously receive HPN. Results: Since May 2011 through February 2016, 127 nonhospitalized cancer patients met all the criteria for receiving HPN; 108 carried out the management with a family caregiver and 19 performed HPN with a general home nurse. The incidence rate of CRBSIs in the first group was 0.6 per 1,000 catheter days, in the second group was 3.1. Time to first CRBSI episode was significantly shorter in the nurse group (Log Rank Test p = 0.001). Multivariable Cox proportional hazards model was used to determine the independent effects of performer’s type in predicting CRBSI’s first episode: the relative risk was significantly lower in the family caregiver group (HR 0.11, 95% CI 0.024–0.510, p = 0.005). Conclusion: The literature reports that the self management of HPN, carried out by trained patient, performs better than nurse care in non-cancer patients (lower incidence of CRBSIs).