A large-scale study conducted across seven tertiary hospitals in China has demonstrated that preoperative immunonutritional status plays a crucial role in determining outcomes for ovarian cancer patients. The research, spanning from January 2012 to February 2023, analyzed data from 922 patients with histologically confirmed epithelial ovarian cancer.
Impact of Nutritional Status on Patient Outcomes
The study revealed that up to 70% of ovarian cancer patients experience malnutrition, which significantly impacts their survival prospects. Poor nutritional status weakens immune response, reduces chemotherapy tolerance, and increases the risk of postoperative infections. Additionally, systemic inflammation was found to promote tumor survival, proliferation, and chemotherapy resistance.
Key Findings from the Analysis
Researchers utilized two primary metrics to assess immunonutritional status: the Prognostic Nutritional Index (PNI) and Systemic Immune-inflammation Index (SII). The study population included 224 patients with early-stage disease (FIGO stage I to IIA) and 698 patients with advanced-stage disease (FIGO stage IIB to IV), with a median age of 52 years.
In early-stage patients, the analysis revealed:
- PNI cutoff value of 47.47 for both overall survival and progression-free survival
- SII cutoff values of 551.37 for progression-free survival and 771.78 for overall survival
- High PNI served as an independent protective factor
- Elevated SII emerged as an independent risk factor
For advanced-stage patients:
- PNI cutoff values were 47.76 for progression-free survival and 46.00 for overall survival
- SII cutoff values were 720.96 and 1686.11 for progression-free and overall survival respectively
Clinical Implications and Survival Outcomes
The median follow-up period of 55.1 months showed significantly longer progression-free and overall survival rates in patients with high PNI and low SII values, regardless of disease stage. Multivariate analysis confirmed these findings, with high PNI showing particular benefit in early-stage disease (HR, 0.39; 95% CI, 0.20-0.76; P = .006 for PFS).
Future Directions in Patient Care
The research team emphasizes the potential of using combined PNI and SII measurements as practical markers for predicting both short-term and long-term survival in ovarian cancer patients. They strongly recommend implementing timely interventions for patients showing poor preoperative immunonutritional status to improve their prognosis.
While the study's limitation to Chinese populations may affect its broader applicability, the findings present compelling evidence for the importance of nutritional status in ovarian cancer treatment outcomes. This research underscores the need for comprehensive preoperative assessment and potential nutritional intervention strategies in ovarian cancer management protocols.
