Prevalence of Malnourished Status and its Relationship to Surgical Outcomes in Women Undergoing Surgery for Gynecologic Cancers
Yanaranop M, MD, PhD1,2, Nutcharas T, MD1
Affiliation : 1 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand 2 College of Medicine, Rangsit University, Bangkok, Thailand
Background : Malnutrition in cancer patients is an important problem and is associated with adverse clinical outcomes.
Objective : To determine the prevalence of malnutrition in women with gynecologic cancers undergoing surgery in Rajavithi Hospital,
Thailand, and to identify malnutrition-associated risk factors for adverse surgical outcomes.
Materials and Methods : This prospective study was conducted on 200 women with gynecologic cancer undergoing elective surgery
at Rajavithi Hospital between November 26th, 2015 and March 10th, 2016. The nutritional status of participants, assessed by subjective
global assessment, length of hospital stay and postoperative complications at 7 and 30 days post-surgery, were recorded.
Postoperative complications were classified according to the Clavien classification system.
Results : Malnourished patients accounted for 25.5% of participants. Factors associated with malnutrition status included ovarian,
Fallopian tube and peritoneal cancers, advanced or recurrent stage of disease, high Eastern Cooperative Oncology Group score, low
serum albumin concentrations, and a high platelet-to-lymphocyte ratio. A statistical interaction between subjective global assessment
and serum albumin was a significant prognostic factor for postoperative complications (adjusted odds ratio 10.9, p = 0.018) and
length of hospital stay (adjusted mean difference 8.3 days, p<0.001). Respiratory complications were more common in moderately-
malnourished than in well-nourished participants (22.0 vs. 3.8%, p<0.001).
Conclusion : Malnutrition is a significant problem which is found in approximately 21% of gynecologic cancer patients. Pre-operative
malnutrition is an important predictor of poor clinical outcomes in those undergoing surgery.
Keywords : Nutrition, Operative outcomes, Gynecologic cancer
