Abstract 1839P
Background
Preventable weight loss (WL) may occur during SACT, causing treatment disruption and poorer prognoses. UK cancer patients must be screened for malnutrition yet nutritional support varies by cancer type and provider during treatment. A body mass index (BMI)-adjusted WL grading (WLG) system predicts patient survival differences independent of cancer type (Martin, 2015). We aimed to quantify WL during SACT across 18 cancer types and identify cancers with WL-associated treatment modification (TM), targets for nutritional intervention.
Methods
A cross-sectional study used SACT and Cancer Outcomes and Services Dataset (COSD) datasets from England’s Cancer Analysis System. Study population included SACT-treated adults with a single tumour and ≥2 weight recordings from 01 Jan 2014 to 31 Mar 2018. Patient weight and 3 types of TM; dose reduction (DR); time delay (TD); stopped early (SE), may be recorded for each SACT received. Binary WL (‘Yes’: ≥2.5%; ‘No’: <2.5%) was derived from patients’ most negative % weight change from first weight recording (baseline). BMI-WLG (0-4) was assigned using the same % weight change and baseline BMI. We created a TM-status composite outcome, ‘yes’ patients had one of DR, TD or SE and no prior missing TM data. ‘No’ patients had no recorded TMs or missing TM data. We described binary WL, BMI-WLG and TM by cancer. Logistic regression models examined relationships between binary WL/BMI-WLG and composite outcome.
Results
Of our study population (N=200536), 28% had binary WL. WL patients were more likely to have 2 or more types of TM recorded than non-WL patients in all cancers. 86991 patients were eligible for regression analyses. Binary WL was associated (p<0.05) with higher likelihood of TM in; colon (Odds Ratio [OR]=1.72); gynaecologic (OR=1.48); stomach (OR=1.6); lung (OR=1.38); leukaemia (OR=1.30); head and neck (OR=1.30) and oesophageal (OR=1.29) cancers. In lung, colon and grouped gastro-intestinal cancers, association between BMI-WLG and TM increased by WLG.
Conclusions
Our study includes novel use of BMI-WLGs and England’s SACT dataset. Due to WL, patients are having TMs during SACT, a precursor to worse prognosis. Our findings highlight cancers that may benefit from nutritional intervention during SACT.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Baxter Healthcare Ltd.
Disclosure
A. Reich; E. Wilkes: Research grant/Funding (institution): Baxter Healthcare Ltd. R. White; J. Shepelev: Full/Part-time employment: Baxter Heathcare Ltd. S. Narduzzi: Research grant/Funding (institution): Baxter Healthcare Ltd. All other authors have declared no conflicts of interest.