Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Pre-operative Malnutrition in Patients with Ovarian Cancer: What are the Clinical Implications? Results of a Prospective Study

Sara Nasser
* ORCID logo ,
Esra Bilir
ORCID logo ,
Xezal Derin
,
Rolf Richter
,
Jacek P Grabowski
,
Paulina Ali
,
Hagen Kulbe
,
Radoslav Chekerov
,
Elena Braicu
,
Jalid Sehouli
ORCID logo
Version 1 : Received: 9 November 2023 / Approved: 10 November 2023 / Online: 13 November 2023 (08:32:41 CET)

A peer-reviewed article of this Preprint also exists.

Nasser, S.; Bilir, E.; Derin, X.; Richter, R.; Grabowski, J.P.; Ali, P.; Kulbe, H.; Chekerov, R.; Braicu, E.; Sehouli, J. Pre-Operative Malnutrition in Patients with Ovarian Cancer: What Are the Clinical Implications? Results of a Prospective Study. Cancers 2024, 16, 622. Nasser, S.; Bilir, E.; Derin, X.; Richter, R.; Grabowski, J.P.; Ali, P.; Kulbe, H.; Chekerov, R.; Braicu, E.; Sehouli, J. Pre-Operative Malnutrition in Patients with Ovarian Cancer: What Are the Clinical Implications? Results of a Prospective Study. Cancers 2024, 16, 622.

Abstract

Background: Malnutrition was associated with worse survival outcomes, impaired quality of life, and deteriorated performance status across various cancer types. We aimed to identify risk factors for malnutrition in patients with epithelial ovarian(EOC) and impact on survival. Methods: In our prospective study, we included the patients with primary and recurrent EOC, tubal or peritoneal cancer conducted. We assessed serum laboratory parameters, body mass index, nutritional risk index, nutritional risk screening score(NRS-2002), and bio-electrical impedance analysis. Results: We recruited a total of 152. Patients >65 years-old, with ascites of >500 ml, or with platinum-resistant EOC showed statistically significant increased risk of malnutrition when evaluated by NRS-2002(p-values = 0.014, 0.001, and 0.007, respectively). An NRS-2002<3 was an independent predictive factor for complete tumor resectability (p=0.009). The patients with NRS-2002≥3 had a median overall survival(OS) of seven months (95% CI=0-24 months), as compared to the patients with NRS-2002<3 where median OS was 46 months(p=0,001). Phase angle(PhAα)≤ 4.5 was the strongest predictor of OS. Conclusion: Malnutrition is an independent predictor of incomplete cytoreduction in study population. It is an independent prognostic factor for poor OS. Preoperative nutritional assessment is an effective tool in identification of high-risk groups within EOC characterized by poor clinical outcome.

Keywords

malnutrition; ovarian cancer; overall survival; nutritional risk screening score; nutrition; phase angle; progression-free survival

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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