Peri-operative oral immunonutrition in malnourished ovarian cancer patients assessed by the nutritional risk screening

Arch Gynecol Obstet. 2018 Jun;297(6):1533-1538. doi: 10.1007/s00404-018-4759-8. Epub 2018 Apr 5.

Abstract

Objectives: Aim of this study was to determine whether peri-operative immunonutrition can decrease complications and the length of stay (LOS) in malnourished ovarian cancer patients.

Study design: Patients suspicious for advanced ovarian cancer before histopathological diagnosis and a nutritional risk score (NRS) ≥ 3 received oral immune-modulating diets (IMDs) for 5 days pre-operative and at least 5 days post-operative. Parameters for clinical outcome were infectious and non-infectious complications during hospital stay, and time of hospitalization. The results were compared with malnourished ovarian cancer patients of a previous study without any additive nutritional support (standard clinical diet/nutrition).

Results: The infectious and non-infectious complication rate in the interventional group (IG) N = 28 was 42.9%, similar to the control group (CG) N = 19 with 42.1%, whereas the rate of infectious complications in the IG (21.4%) was slightly lower compared to the CG (26.3%). The median LOS of the IG was 18 days, and therefore, longer than LOS of the CG (15 days). Regarding the patients' compliance pre-operative 78.6% of the patients took the IMDs in an optimal and sufficient amount. Whereas after surgery, only eight (28.6%) patients were able to take IMDs in optimal and sufficient amount.

Conclusions: The current study showed no improvement of the complication rate or the time of hospitalization due to additional peri-operative immunonutrition in malnourished ovarian cancer patients. However, a trend towards the reduction of infectious complications could be seen in the IG.

Keywords: Immunonutrition; Malnutrition; NRS score; Ovarian cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Immunotherapy / methods*
  • Length of Stay / statistics & numerical data*
  • Malnutrition / etiology
  • Malnutrition / therapy*
  • Middle Aged
  • Nutrition Assessment
  • Nutrition Therapy*
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Postoperative Period
  • Prospective Studies