The impact of preoperative immunonutritional status on postoperative complications in ovarian cancer.

IF 3.8 3区医学 Q1 REPRODUCTIVE BIOLOGY

Journal of Ovarian Research Pub Date : 2025-04-29 DOI:10.1186/s13048-025-01624-3

Xingyu Liu, Ming Li, Yingjun Zhao, Xiaofei Jiao, Yang Yu, Ruyuan Li, Shaoqing Zeng, Jianhua Chi, Guanchen Ma, Yabing Huo, Zikun Peng, Jiahao Liu, Qi Zhou, Dongling Zou, Li Wang, Qingshui Li, Jing Wang, Shuzhong Yao, Youguo Chen, Ding Ma, Ting Hu, Qinglei Gao

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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Clinical trial registration: The study was registered in the Clinical trial registry: NCT06483399. ( https://clinicaltrials.gov/study/NCT06483399 ).

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术前免疫营养状况对卵巢癌术后并发症的影响。

背景：术前免疫营养状况可影响术后并发症。卵巢癌患者的营养不良降低了身体对腹部手术的适应能力，导致手术效果较差，术后并发症增加。我们旨在研究包括NLR、PLR、LMR、TCLR、FAR、FLR、SII、PNI和CONUT在内的术前免疫营养状况对上皮性卵巢癌（EOC）术后并发症的影响。方法：一项多中心现实世界研究纳入了922例组织学证实的EOC患者，这些患者于2012年至2023年在中国7家三级医院接受了综合分期手术或减积手术。采用Logistic回归和Lasso回归分析确定与术后并发症相关的变量。在多变量建模的基础上建立了预测模态图模型。结果：该研究包括7个医疗中心共922名被诊断为上皮性卵巢癌的患者，其中565名（61.3%）患者出现术后并发症。两组患者炎症及营养危险指标NLR、PLR、LMR、TCLR、FAR、FLR、SII、PNI、CONUT分布差异均有统计学意义(P均为46.73(优势比[OR] = 0.49, P = 10.77 (OR = 1.60, P = 0.019), LMR > 3.70 （OR = 0.68, P = 0.044）、胸水（OR = 2.60, P = 0.005）、腹腔镜（OR = 0.59, P = 0.010）、肠切除术（OR = 2.50, P = 0.001）。结论：不良的免疫营养状况可增加术后并发症的发生风险。这些发现表明，及时的营养干预可以减少术后并发症的发生率，改善手术效果。风险预测模型包括PNI、FAR、LMR、胸腔积液、腹腔镜、开腹和肠切除术，可能有助于以患者为中心的决策和风险分层。临床试验注册：本研究在临床试验注册中心注册：NCT06483399。（https://clinicaltrials.gov/study/NCT06483399）。

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来源期刊

Journal of Ovarian Research REPRODUCTIVE BIOLOGY-

CiteScore

6.20

自引率

2.50%

发文量

125

审稿时长

>12 weeks

期刊介绍： Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.