Peri-operative oral immunonutrition in malnourished ovarian cancer patients assessed by the nutritional risk screening
- 26 Downloads
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.
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).
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.
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.
KeywordsImmunonutrition Malnutrition NRS score Ovarian cancer
Nutritional risk screening
Body mass index
Length of stay
We thank Anna Müller for support in patients’ recruitment. In addition, we thank Andrea Malota, MD for language revision.
LH: Protocol development, Data collection, Data analysis. Manuscript writing: CZ-G: Data collection; SF: Data collection. DB: Data collection; FT: Data analysis. BC: Data analysis; SM: Manuscript editing. AB: Protocol development, Data collection. PR: Protocol development, Data analysis, Manuscript editing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 6.Kemen M, Senkal M, Homann HH, Mumme A, Dauphin AK, Baier J et al (1995) Early postoperative enteral nutrition with arginine-omega-3 fatty acids and ribonucleic acid-supplemented diet versus placebo in cancer patients: an immunologic evaluation of Impact. Crit Care Med 23(4):652–659CrossRefPubMedGoogle Scholar
- 9.Senkal M, Zumtobel V, Bauer KH, Marpe B, Wolfram G, Frei A et al (1999) Outcome and cost-effectiveness of perioperative enteral immunonutrition in patients undergoing elective upper gastrointestinal tract surgery: a prospective randomized study. Arch Surg (Chicago, Ill: 1960) 134(12):1309–1316CrossRefGoogle Scholar
- 12.Billson HA, Holland C, Curwell J, Davey VL, Kinsey L, Lawton LJ et al (2013) Perioperative nutrition interventions for women with ovarian cancer. Cochrane Database Syst Rev. 9:CD009884Google Scholar
- 16.Weimann A, Breitenstein S, Breuer JP, Gabor SE, Holland-Cunz S, Kemen M et al (2014) Clinical nutrition in surgery. Guidelines of the German Society for Nutritional Medicine. Der Chirurg Z Alle Gebiete Oper Med 85(4):320–326 (Klinische Ernahrung in der Chirurgie. S3-Leitlinie der Deutschen Gesellschaft fur Ernahrungsmedizin e. V. Ger) Google Scholar
- 20.Symeonidis PD, Clark D (2006) Assessment of malnutrition in hip fracture patients: effects on surgical delay, hospital stay and mortality. Acta Orthop Belgica 72(4):420–427Google Scholar