P58 IMPACT OF SYSTEMATIC ENTERAL NUTRITION IN OESOPHAGEAL OR OESOGASTRIC JUNCTION (OG) CANCERS INVOLVED IN A CURATIVE STRATEGY
Abstract Aim In the absence of severe dysphagia or major weight loss, most patients treated for OG cancer do not have enteral nutrition (EN) instituted before neoadjuvant treatment. The aim of this work was to compare the impact of a systematic NE (NES) or on demand (NED) on the course of the therapeutic sequence, the post-operative follow-up: post-operative complications of grade Clavien-Dindo> II and Complication Comprehensive Index (CCI); and oncologic results (median follow-up: 36 months). Background & Methods Among 682 patients with OG cancer operated between 2007 and 2015, 313 patients with <20% weight loss and no severe dysphagia (Atkinson <IV) were included. Control group with NES (n = 140) and group with NED (n = 173) were compared with propensity score adjustment. Results In the NES group, the tumor stage was more advanced (clinical stage III: 78.6% vs 61.4% p = 0.001) and the more frequent undernutrition (28.6% vs 14.6% p = 0.002). After adjustment, there was no significant difference between the two groups regarding the risk of severe complications (25.7% vs 24.9% p = 0.682), the median CCI (20.9 vs 20.9, p = 0.08) and 90-day mortality (4.3% vs. 5.2% p = 0.706). In case of perioperative chemotherapy, the rate of patients benefiting from the complete therapeutic sequence was higher in the NES group (80.4% vs 62.2% p = 0.0192 ie OR = 2.5). Overall survival was similar between the 2 groups (p = 0.509). Conclusion In OG cancers, systematic NE does not modify the operative and oncological follow-ups with respect to an on-demand NE, but more frequently makes it possible to achive the therapeutic sequence in the case of perioperative chemotherapy.