Weight Loss after Minimally-Invasive Esophagectomy for Esophageal Cancer

e16565 Background: Nutritional deficiencies are common in esophageal cancer patients after esophagectomy. Patients frequently present with weight loss due to obstruction. Cancer therapies (chemoradiation and esophagectomy) further compromise nutrient intake through alterations in appetite, gastrointestinal function, and the catabolic effects of therapy. We aimed to understand and identify risk factors associated with post-esophagectomy weight loss. Methods: Patients undergoing minimally-invasive esophagectomy via laparoscopic and thoracoscopic techniques with intra-thoracic anastomosis between January 2015 and July 2019 were identified. Post-operative weight loss at 3- and 6-months post-surgery was calculated as percent change from preoperative weight. Univariate and multivariable generalized linear method (GLM) analysis was performed. Results: 176 patients (145 male, 31 female) underwent esophagectomy, with a median age of 64 [IQR 57-71] and median 3-month postoperative weight loss of 7.9% [IQR 1.5-12.3%]. The majority of patients were Caucasian (89%), histologically diagnosed adenocarcinoma (90%), and received neoadjuvant chemoradiation (71%). Median preoperative BMI was 28.3 [IQR 25.5-32.5]. Preoperative enteral feeding tubes were placed in 86 patients (49%). Five patients (2.8%) were converted to open surgery (laparotomy) and anastomotic leaks occurred in 12 (6.8%) patients. The median length of stay was 9 days [IQR 8-13]. Among a subset of 147 patients with data available, the median 6-month postoperative weight loss was 10% [IQR 5.3-15.0%]. On multivariable analysis, greater preoperative BMI and anastomotic leak were associated with increased weight loss at 3 and 6 months post-esophagectomy. Conclusions: Significant postoperative weight loss is common among minimally-invasive esophagectomy patients. Higher preoperative BMI and postoperative anastomotic complications are significantly associated with increased postoperative weight loss at 3 and 6 months. Need for preoperative feeding tube and conversion to open surgery were further associated with postoperative weight loss. [Table: see text]