Nutritional interventions during treatment for ovarian cancer: A narrative review and recommendations for future research Original paper

What was studied?

This narrative review explores the impact of nutritional interventions during ovarian cancer treatment, focusing on their effects on nutritional status, muscle mass, and clinical outcomes. The study evaluates various types of interventions, including individual nutrition counseling, oral nutritional supplements, perioperative immunonutrition, and exercise interventions. The review highlights the importance of addressing malnutrition and muscle loss, which are prevalent in ovarian cancer patients, particularly due to the hypermetabolic state caused by the cancer itself and its treatments. It also investigates the role of personalized nutrition care to mitigate treatment-related side effects and improve patient survival and quality of life.

Who was studied?

The review compiles evidence from multiple studies on women diagnosed with ovarian cancer, primarily in advanced stages (III and IV). These studies include various treatment regimens such as surgery, chemotherapy, and sometimes radiotherapy. The patients in the reviewed studies had varying nutritional statuses, many presenting with malnutrition or muscle loss at the time of diagnosis. The sample sizes varied across studies, ranging from small cohorts in pilot studies to larger retrospective and prospective cohort studies. The majority of the women studied had ovarian cancer at stages where malnutrition and muscle loss were already prevalent due to the disease and its treatment.

Most important findings

One of the key findings from the review is the widespread prevalence of malnutrition and muscle loss in women with ovarian cancer. Around 70% of these patients experience malnutrition at diagnosis, and approximately 40% suffer from muscle loss, which negatively impacts treatment outcomes. The review highlights several interventions that have shown promise, particularly individualized nutrition counseling and oral nutritional supplements, which have been associated with improvements in nutritional status and survival outcomes. The review also found that perioperative immunonutrition could reduce complications and length of hospital stays, though the results were inconsistent across studies. Nutrition and exercise interventions, such as multimodal prehabilitation programs, demonstrated improvements in dietary intake, muscle mass preservation, and overall quality of life during chemotherapy treatment. Notably, a retrospective study showed that improved nutritional status was linked to significantly better survival outcomes.

Key implications

The findings suggest that early and individualized nutritional interventions are critical for women with ovarian cancer, particularly during treatment. These interventions can prevent further nutritional decline, support muscle mass preservation, and improve clinical outcomes, such as reducing chemotherapy toxicities and improving overall survival. However, the review emphasizes that while the evidence is promising, there is a critical need for larger, more robust prospective studies to confirm these benefits and develop comprehensive clinical guidelines. The importance of integrating nutrition care into routine cancer treatment is clear, but future research should focus on the long-term impact of nutritional interventions, particularly after treatment ends, to prevent ongoing declines in nutritional status and muscle mass.