AHP P02 Retrospective study reviewing post-operative feeding after gastric cancer surgery and the impact on outcomes

Abstract

Abstract Background Gastric cancer patients are at increased risk of disease-related malnutrition due to the disease and the consequences of treatment. The variation in post-operative nutrition for this patient group may be impacting on outcomes, and further research has been recommended by the National Institute for Health and Care Excellence to help ascertain the safest and most effective method of nutrition support. The aim of this study was to help inform best practice regarding nutrition post-gastrectomy. The outcomes reviewed included length of stay (LOS), weight changes, complications and readmissions, and chemotherapy completion rates. Methods A regional tertiary Oesophago-gastric Centre was the setting for this study. Quantitative data of patients who had a gastrectomy secondary to gastric cancer over a 12-month period was collated. Weights from four timepoints during the multimodal treatment pathway were included. Baseline characteristics were reviewed, and patients grouped based upon their post-operative feeding route (no artificial nutrition, enteral nutrition, parenteral nutrition). Patients were also stratified by resection (partial, total or extended-total). IBM SPSS v26 was utilised for data analysis. Non-parametric tests were used as much of the data was not normally distributed. Results 44 patients were included, (35 males) age 34-84 years. Partial gastrectomy patients lost an average of 7.2% bodyweight by six months post-operatively, versus 16.5% and 10.7% amongst those who had total and extended-total procedures. 27% (n=12) were known to be readmitted within six months of surgery, half with nutrition-related complaints. 19 patients received adjuvant chemotherapy, with 52% known to complete this. Weight loss in the initial post-operative period between those who did and did not complete chemotherapy was significantly different (6.8% versus 8.6%) (p=0.027). The patients with supplementary enteral nutrition completed chemotherapy, versus half of those only receiving oral nutrition. Conclusions Weight loss and inadequate nutrition after gastrectomy is significant and may have an impact on treatment pathways including the need for readmission. The study demonstrates a relationship between post-operative nutrition and adjuvant chemotherapy completion and warrants future prospective investigation. The study highlights the importance of providing adequate nutrition support throughout treatment and beyond for those patients undergoing a resection for gastric cancer.