4813 - Differential of the nutritional index before and after neoadjuvant chemoradiotherapy as a prognostic factor of recurrence in patients with locally advanced adenocarcinoma of the rectum

Background

The Nutritional Prognostic Index (INP) is a nutritional and immunological marker. The difference between concomitant pre and post chemoradiotherapy INP and its impact as a prognostic factor for recurrence in patients with locally advanced rectal adenocarcinoma remains unclear. With the aim of providing greater evidence of the recurrent prognostic role of the differential of the pre and post INP in patients with locally advanced rectal adenocarcinoma we carried out the present study.

Methods

Of the total of 206 patients, 74 patients were excluded. The analysis included 132 patients. INP formula: 10 * serum albumin (g / dL) + 0.005 * total lymphocyte count (per mm³). The INP values were determined in 2 points: before QT/RTneoadjuvant (preQT/RT INP ) and after the neoadjuvant QT/RT termination, (postQT/RT PNI). The difference in INP (dINP) was calculated with the formula: preQT/RT INP - postQT/RT INP.

Results

Table:

546P Univariate and multivariate analysis

In the Kaplan and meier analysis, recurrence free survival (SLR) was P = 0.03. Independent factors for recurrence were age and ECOG (95% CI 0.940 – 0.998¸ P = 0.037, HR 3.4 95% IC 1.26 – 9.6, P = 0.016). Our findings showed a better SLR in the low dINP subgroup, so we took it as a cutoff 5. Patients who presented a dINP less than 5, have a better SLR in relation to those who have a dINP > 5. P = 0.013.

Conclusions

The difference less than 5 between the nutritional index before and after neoadjuvant chemoradiotherapy in patients with locally advanced adenocarcinoma of the rectum is associated with an increase in SLR as an independent predictor of recurrence.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.