Benoit Louise, Boudebza Alizée, Bentivegna Enrica, Nguyen-Xuan Huyen-Thu, Azaïs Henri, Bats Anne-Sophie, Koual Meriem
Gynecologic and Breast Oncologic Surgery Department, Georges Pompidou European Hospital, APHP. Centre, Université de Paris, Paris, France; INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saint-Père, Paris, France.
Gynecologic and Breast Oncologic Surgery Department, Georges Pompidou European Hospital, APHP. Centre, Université de Paris, Paris, France.
Gynecol Oncol. 2024 Feb;181:12-19. doi: 10.1016/j.ygyno.2023.12.003. Epub 2023 Dec 14.
Malnutrition is common in ovarian cancer and is a major cause of morbidity and mortality. We aimed to define the most pertinent way to assess malnutrition in patients with epithelial ovarian cancer (EOC) in order to study its impact on morbidity (intra and post-operative complications) and survival (OS, overall survival and RFS, recurrence-free survival).
We retrospectively included all patients with EOC from 2003 to 2020. Nutritional status was assessed using the weight loss at diagnosis (more or <5%), albuminemia, the Nutritional Risk Index (NRI), and the Malnutrition Universal Screening Tool (MUST).
Six hundred and fifteen patients were included. Among them, 34% declared having lost >5% of their usual weight, 58% had an albuminemia <35 g/L, 86% presented an abnormal NRI and 29% an abnormal MUST score. After univariate analysis, weight loss>5% appeared to be significantly associated with RFS. An abnormal NRI or MUST score were significantly associated with a decrease in OS in univariate analysis. None of the markers of malnutrition studied were correlated with morbidity.
We were not able to reach a consensus concerning the most accurate definition to define malnutrition and predict morbidity and mortality in EOC. However, this modifiable prognosis factor must be systematically assessed and managed accordingly.
营养不良在卵巢癌中很常见，是发病和死亡的主要原因。我们旨在确定评估上皮性卵巢癌（EOC）患者营养不良的最相关方法，以研究其对发病率（术中及术后并发症）和生存率（总生存期[OS]和无复发生存期[RFS]）的影响。
我们回顾性纳入了2003年至2020年期间所有EOC患者。使用诊断时体重减轻情况（>或<5%）、白蛋白水平、营养风险指数（NRI）和营养不良通用筛查工具（MUST）评估营养状况。
共纳入615例患者。其中，34%的患者自述体重减轻超过其平常体重的5%，58%的患者白蛋白水平<35g/L，86%的患者NRI异常，29%的患者MUST评分异常。单因素分析后，体重减轻>5%似乎与RFS显著相关。单因素分析中，NRI或MUST评分异常与OS降低显著相关。所研究的营养不良标志物均与发病率无关。
我们无法就定义EOC患者营养不良以及预测其发病率和死亡率的最准确定义达成共识。然而，这个可改变的预后因素必须进行系统评估并相应处理。
