Abstract 1428P
Background
Advanced gastroesophageal cancer is a devastating disease with poor outcome. Due to symptoms such as dysphagia and weight loss, patients often suffer from nutritional deficits. However, the potential impact of circulating nutritional biomarkers on the overall survival (OS) is not fully understood. Thus, the aim of this analysis was to investigate the prognostic potential of circulating nutritional biomarkers in a large European cohort of stage IV gastroesophageal cancer patients.
Methods
We evaluated laboratory parameters at initial diagnosis including electrolytes, albumin and C-reactive protein (CRP), and their association with the outcome in patients with stage IV gastroesophageal cancer treated at the Medical University of Vienna between 1990 and 2020.
Results
In total, the survival of 409 patients (82% adeno, 18% squamous cell carcinoma) was evaluated, of which 363 (89%) patients were dead at the time of analysis. Alterations in sodium (p=0.032), potassium (p=0.005), chloride (p=0.010), magnesium (p≤0.001), albumin (p≤0.001) and CRP (p≤0.001) levels were significantly associated with poorer OS. Changes in calcium (p=0.184) and phosphate (p=0.328) levels were not. OS data is shown in the Table. Table: 1428P
Circulating nutritional biomarkers categorized in within/above/below the normal limit and their association with the OS
| Category | n (%) | median OS in months (95%CI) | |
| Na | Within | 351 (90%) | 10.5 (9.2-11.8) |
| Above | 6 (1%) | 2.7 (0.0-6.2) | |
| Below | 35 (9%) | 5.5 (3.0-8.0) | |
| K | Within | 339 (89%) | 10.4 (9.0-11.8) |
| Above | 10 (3%) | 8.5 (1.7-15.3) | |
| Below | 32 (8%) | 6.0 (2.8-9.2) | |
| Cl | Within | 313 (81%) | 11.0 (9.7-12.3) |
| Above | 19 (5%) | 7.0 (1.6-12.4) | |
| Below | 53 (14%) | 6.4 (5.1-7.7) | |
| Mg | Within | 325 (94%) | 10.1 (8.6-11.6) |
| Above | 3 (1%) | 2.3 (0.7-3.9) | |
| Below | 18 (5%) | 4.5 (3.3-5.7) | |
| Alb | Within | 269 (76%) | 11.3 (10.1-12.5) |
| Below | 84 (24%) | 5.2 (3.1-7.3) | |
| CRP | Within | 110 (29%) | 13.8 (11.3-16.3) |
| Above | 270 (71%) | 7.8 (6.7-8.9) |
Conclusions
The results of this analysis suggest that alterations of circulating nutritional biomarkers might be of some prognostic value in patients with metastatic gastroesophageal cancer. This study is an important impulse for future prospective studies on nutrition counselling in this patient cohort.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
H.C. Puhr: Other, Personal and Institutional, Other, HC.P. has received travel support from Eli Lilly, MSD, Novartis, Pfizer and Roche.: HC.P. has received travel support from Eli Lilly, MSD, Novartis, Pfizer and Roche. A.S. Berghoff: Other, Personal and Institutional, Other, AS.B. has received research support from Daiichi Sankyo and Roche, honoraria for lectures, consultation or advisory board participation from Roche, Bristol-Meyers Squibb, Merck, Daiichi Sankyo as well as travel support from Roche, Amgen, Daiichi Sankyo and AbbVie.: AS.B. has received research support from Daiichi Sankyo and Roche, honoraria for lectures, consultation or advisory board participation from Roche, Bristol-Meyers Squibb, Merck, Daiichi Sankyo as well as travel support from Roche, Amgen, Daiichi Sankyo an. M. Preusser: Other, Personal and Institutional, Other, M.P. has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journals, MedMedia, AstraZeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, Tocagen. The following for-profit companies have supported clinical trials and contracted research conducted by M.P. with payments made to his institution: Böhringer-Ingelheim, Bristol-Myers Squibb, Roche, Daiichi Sankyo, Merck Sharp & Dome, Novocure, GlaxoSmithKline, AbbVie.: M.P. has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journ. A. Ilhan-Mutlu: Other, Personal and Institutional, Other, A.I-M. participated in advisory boards of MSD, BMS and Servier, received lecture honoraria from Eli Lilly, MSD, BMS and Servier, is the local PI for clinical trials sponsored by BMS and Roche and received travel support from BMS, Daiichi Sankyo, Eli Lilly and Roche.: A.I-M. participated in advisory boards of MSD, BMS and Servier, received lecture honoraria from Eli Lilly, MSD, BMS and Servier, is the local PI for clinical trials sponsored by BMS and Roche and received travel support from BMS, Daiichi Sankyo, Eli Lilly. All other authors have declared no conflicts of interest.