Preoperative immunonutrition for patients who undergo primary cytoreductive surgery for ovarian cancer.

Abstract

Objective: The role of preoperative immunonutrition interventions in patients with gynecologic malignancies has not been well studied.

Methods: We performed a prospective observational study to assess the feasibility of a preoperative immunonutrition supplementation plan in patients with advanced ovarian cancer who underwent primary cytoreductive surgery between August 2019 and November 2022. Patients were encouraged to consume the provided immunonutrition supplement at each meal for up to 7 days prior to surgery. Patients completed standardized daily intake surveys, as well as laboratory tests and weight measurements throughout the study.

Results: A total of 29 patients were enrolled, 17 of whom met the inclusion criteria. Participants demonstrated a median weight gain of 3.8 kg over the study period, with high compliance, consuming an average of 2.2 Ensure Surgery Immunonutrition Shakes per day. On the day of surgery, 16 of 17 patients (94%) found the supplement satisfying, and 12 (71%) reported feeling better prepared for surgery. The median postoperative hospital stay was 8 days (interquartile range; 6-9), and the median time from surgery to initiation of chemotherapy was 36 days (interquartile range; 35-40). Preoperative laboratory assessments showed significant increases in neutrophils (+4.27 cells/μL, p < .001), C-reactive protein (+23.03 mg/L, p < .001), interleukin-6 (+160.22 pg/mL, p < .001), and interleukin-10 (+4.62 pg/mL, p = .279).

Conclusions: Implementing a preoperative immunonutrition supplementation program in patients with advanced ovarian cancer undergoing primary cytoreductive surgery is feasible, and future studies are warranted to determine whether such a program improves patient outcomes.