The impact of preoperative immunonutritional status on postoperative complications in ovarian cancer
Preoperative immunonutritional status can influence postoperative complications. Malnutrition in ovarian cancer patients diminishes the body's resilience to abdominal surgery, resulting in inferior surgical outcomes and increased postoperative complications. We aim to investigate the effect of preoperative immunonutritional status, including NLR, PLR, LMR, TCLR, FAR, FLR, SII, PNI and CONUT on postoperative complications in epithelial ovarian cancer (EOC) in a large population. A multicenter real-world study included 922 patients with histologically confirmed EOC who received comprehensive staged surgery or debulking surgery at seven tertiary hospitals in China between 2012 and 2023. Logistic regression and Lasso regression analyses were employed to identify variables associated with postoperative complications. A predictive nomogram model was developed based on multivariate modeling. The study included a total of 922 patients diagnosed with epithelial ovarian cancer across seven medical centers with 565 (61.3%) patients experiencing postoperative complications. Significant differences were found in the distribution of inflammatory and nutritional risk indicators, including NLR, PLR, LMR, TCLR, FAR, FLR, SII, PNI and CONUT between the two groups (all P < 0.01). A multivariable model identified several predictive factors for postoperative complications: PNI > 46.73 (odds ratio [OR] = 0.49, P < 0.001), FAR > 10.77 (OR = 1.60, P = 0.019), LMR > 3.70 (OR = 0.68, P = 0.044), hydrothorax (OR = 2.60, P = 0.005), laparoscopy (OR = 0.59, P = 0.010 vs. laparotomy), enterectomy (OR = 2.50, P = 0.001). Poor immunonutritional status can increase the risk of postoperative complications. These findings suggest that prompt nutritional interventions may reduce the incidence of postoperative complications and improve surgical outcomes. The risk prediction model, including PNI, FAR, LMR, hydrothorax, laparoscopy vs. laparotomy, and enterectomy, might facilitate patient-centered decision-making and risk stratification. The study was registered in the Clinical trial registry: NCT06483399. ( https://clinicaltrials.gov/study/NCT06483399 ).
Journal
Journal of Ovarian ResearchInstitutions
Authors
Funding
National Key Research and Development Program of China Grant 2022YFC2704200National Natural Science Foundation of China Grant 81772787, 82072889Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Major Project of Chinese Society of Medical Education Grant 20A0769Beijing Xisike Clinical Oncology Research Foundation Grant Y-2019AZZD-0359, Y-2019AZQN-0385