P116 A PILOT STUDY ON ENERGY INTAKE AND TOTAL ENERGY EXPENDITURE, USING A MULTI SENSOR DEVICE, IN OESOPHAGEAL CANCER PATIENTS DURING THE ENTIRE COURSE OF MODERN MULTIMODALITY TREATMENT

Abstract

Abstract Aim The objective of the present pilot study was to address the feasibility and practical use of SenseWear Armband Mini® (SWA) as a possible valid method offering longitudinal, comprehensive and complete assessment of energy balance in oesophageal cancer patients submitted to modern multimodality therapy. Background and methods Assessment of malnutrition and its consequences are pivotal in the curative management of patients with oesophageal cancer. Twenty patients were recruited at diagnosis of oesophageal cancer, all amenable for curative treatment. The baseline measurement took place before start of neoadjuvant treatment and at three additional measurement periods: after the completion of neoadjuvant treatment, and at three and six months postoperatively. The patients carried the SWA for three consecutive days at each measurement period, allowing the measurement of free-living total energy expenditure (TEE) and physical activity level (PAL). Alongside, a three-day food diary was recorded, permitted the calculation of energy and protein intake. The body weigth was measured at all four occasions. Results Body weight steadily decreased during the preoperative phase. However, the greatest weight loss was observed during the first 3 months after surgery (mean=5.6 kg), where after it stabilised. The median energy intake of 1982 kcal (range: 910-3455) at baseline increased to 2210 kcal (range: 1718-3355, p=0.009) after the completion of the neoadjuvant treatment. At 3 months after oesophagectomy energy intake decreased to 1749 kcal (range: 1024-2707, p=0.101) and regained baseline levels first at 6 months postoperatively. The same trend was observed regarding protein intake. The TEE was 2262 kcal (range: 1595-3150) at baseline with no change after preoperative oncological treatment. A significant reduction in energy expenditure to 1975 kcal (range 1396-2336, p=0.005) was recorded at 3 months post oesophagectomy, which remained unchanged at six months after surgery. Conclusion There are significant obstacles in recording complete, comprehensive and repetitive data on energy balance during the entire course of modern multimodality treatment of oesophageal cancer patients. With the objective to achieve and maintain positive energy balance focus must be on the patients’ energy intake already at the time of diagnosis, throughout the neoadjuvant therapy phase but particularly during the first 3 postoperative months.