(P04-038-25) The Impact of Perioperative Changes in Resting Energy Expenditure on Clavien-Dindo Grade II and Above Complications in Gastric Cancer Patients

Objectives: Gastric cancer is a major malignancy with high morbidity and mortality, ranking third in cancer-related deaths worldwide. Surgery remains the only curative treatment, but metabolic status and nutritional support are crucial for prognosis. Predicting complications and optimizing postoperative nutrition are key research areas. Resting Energy Expenditure (REE) is an important indicator of metabolism and can guide clinical nutrition strategies. However, the relationship between perioperative energy metabolism changes and postoperative complications remains underexplored.

Methods: This study used CCM metabolic vehicles (MEDGRAPHIC) to measure REE via indirect calorimetry, along with glucose and lipid metabolism levels. REE was monitored preoperatively and on postoperative days 1, 3, and 5. The difference between preoperative and postoperative REE showed a significant correlation with grade II complications (p=0.0482, AUC=0.711). The impact of total caloric intake from postoperative nutritional support on complications was also analyzed.

Results: Total caloric intake correlated significantly with grade II complications and above (cut-off = -487.88, AUC=0.763), highlighting the importance of adequate nutrition. However, the glyco-lipid ratio was a poor predictor (AUC=0.481), suggesting that total calorie intake should be prioritized over macronutrient composition.

Conclusions: Monitoring REE is a valuable tool for assessing postoperative recovery and complication risk. REE changes may reflect metabolic status, inflammation, immune function, and recovery capacity. Further research on REE’s biological mechanisms could refine nutritional strategies. Additionally, clinical factors like gender, age, height, and weight significantly influenced REE (P <0.01), underscoring the need for individualized nutrition. Tumor T-stage correlated with lipid metabolism (P <0.05), while N-stage showed a stronger correlation (P <0.01). Lipid metabolism decreased after neoadjuvant therapy (P=0.0159), suggesting tumor progression affects metabolism. Continuous REE monitoring throughout treatment could optimize clinical outcomes by enabling timely adjustments to nutritional support.

Funding Sources: Nanjing Municipal Science and Technology Bureau Project, Research on the Transformation of Biomimetic Nanodrugs for Enhancing Tumor Immunotherapy, 202110018 (JA22).