187. Association between nutritional status and survival in patients requiring treatment for spinal metastases

BACKGROUND CONTEXT Malnutrition is common among cancer patients, and has been associated with profound consequences such as increased morbidity, mortality, risk of complications, length of stay and decreased patient reported treatment outcomes. The Patient Generated Subjective Global Assessment (PG-SGA) is a standardized tool for assessing malnutrition in patients with cancer. PURPOSE The aim of this study was to assess the impact of preoperative nutritional status as measured by PG-SGA on survival for patients requiring surgical intervention and/or radiotherapy for spinal metastases. STUDY DESIGN/SETTING Prospective international multicenter research registry. METHODS Patients with spinal metastases who underwent surgery and/or radiation therapy for symptomatic spinal metastatic disease were enrolled in the AO Spine Metastatic Tumor Research and Outcomes Network (MTRON), between September 2017 and August 2022. Nutritional status is classified into three categories: A – well nourished, B – moderately malnourished, and C-severely malnourished. RESULTS Of the 1,825 patients enrolled in MTRON, 569 met the inclusion criteria; 453 underwent surgery +/- radiation therapy and 116 were treated with radiotherapy alone. Of these, 348 (61%, PG-SGA A) were classified as well-nourished, 155 were moderately malnourished (27%, PG-SGA B), and 66 were severely malnourished (12%, PG-SGA C). The median survival for patients in category A was 475 days, 321 days in category B, and 110 days in category C post-treatment. Patients who required surgical intervention and were malnourished (PG-SGA C) had a significantly increased risk of mortality (HR2.7, p < 0.01) as compared to those who were well-nourished (PG-SGA A). CONCLUSIONS The prevalence of malnutrition among surgically treated patients with spinal metastases is high. Malnutrition as measured by the PG-SGA demonstrated to be significantly and independently associated with postoperative survival. The PG-SGA is a simple tool to identify spinal metastases patients at risk for early postoperative mortality and it is recommended to be included in the preoperative evaluation of these patients. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. Malnutrition is common among cancer patients, and has been associated with profound consequences such as increased morbidity, mortality, risk of complications, length of stay and decreased patient reported treatment outcomes. The Patient Generated Subjective Global Assessment (PG-SGA) is a standardized tool for assessing malnutrition in patients with cancer. The aim of this study was to assess the impact of preoperative nutritional status as measured by PG-SGA on survival for patients requiring surgical intervention and/or radiotherapy for spinal metastases. Prospective international multicenter research registry. Patients with spinal metastases who underwent surgery and/or radiation therapy for symptomatic spinal metastatic disease were enrolled in the AO Spine Metastatic Tumor Research and Outcomes Network (MTRON), between September 2017 and August 2022. Nutritional status is classified into three categories: A – well nourished, B – moderately malnourished, and C-severely malnourished. Of the 1,825 patients enrolled in MTRON, 569 met the inclusion criteria; 453 underwent surgery +/- radiation therapy and 116 were treated with radiotherapy alone. Of these, 348 (61%, PG-SGA A) were classified as well-nourished, 155 were moderately malnourished (27%, PG-SGA B), and 66 were severely malnourished (12%, PG-SGA C). The median survival for patients in category A was 475 days, 321 days in category B, and 110 days in category C post-treatment. Patients who required surgical intervention and were malnourished (PG-SGA C) had a significantly increased risk of mortality (HR2.7, p < 0.01) as compared to those who were well-nourished (PG-SGA A). The prevalence of malnutrition among surgically treated patients with spinal metastases is high. Malnutrition as measured by the PG-SGA demonstrated to be significantly and independently associated with postoperative survival. The PG-SGA is a simple tool to identify spinal metastases patients at risk for early postoperative mortality and it is recommended to be included in the preoperative evaluation of these patients.