490. SIGNIFICANCE OF NUTRITIONAL EVALUATION USING GLIM CRITERIA IN PATIENTS WITH ESOPHAGEAL CANCER

Abstract

Abstract Background Patients with advanced esophageal cancer may have dysphagia and weight loss from the first visit, and it is necessary to evaluate their nutritional status before starting treatment, especially for preoperative patients. On the other hand, since 2018, the global diagnostic criteria for malnutrition, the GLIM criteria, have been proposed to define malnutrition and its severity. Purpose The aim of the study is to examine the impact of malnutrition severity assessment using the GLIM criteria at the time of first visit in patients with advanced esophageal cancer on short-term prognosis (length of hospital stay after surgery) and long-term prognosis (presence or absence of recurrence, OS) in patients undergoing surgery for esophageal cancer. Method From 2011 to 2018, 197 advanced esophageal cancer patients have undergone esophagectomy, and we examined the distribution of malnutrition at the first visit of these patients. Based on the GLIM criteria, low BMI in Asians (<18.5: less than 70 years old, <20: over 70 years old) is defined as malnutrition, and moderate malnutrition and severe malnutrition are defined according to the weight loss rate. Result 42 patients (21.3%) were judged to be malnourished according to the GLIM criteria at the first visit. 23 patients were judged moderately malnourished, and 19 patients were judged severely malnourished. There was no significant difference in postoperative length of hospital stay between the normal nutrition group and the malnutrition group, regardless of the severity of the disease. There was no significant difference in recurrence, but the severely undernourished group had a significantly high rate of recurrences (p < 0.01). Regarding prognosis, the 3-year survival rate tended to be slightly lower in the malnutrition group (p = 0.081), but the 3-year survival rate was significantly lower in the severely malnutrition group (p < 0.001). Conclusion In patients with advanced esophageal cancer, the severe malnutrition group in the GLIM criteria at the time of the first visit was considered to have a poor long-term prognosis, although the short-term prognosis was similar to that of the eutrophic group. Currently, in Japan, NAC is usually performed for operable advanced esophageal cancer, so in the future, we plan to focus on improving the nutritional status from the beginning of NAC to surgery.