Nutritional Interventions to Improve Clinical Outcomes in Ovarian Cancer: A Systematic Review of Randomized Controlled Trials.

Nutrients. 2019;11(6)

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Plain language summary

Ovarian cancer is one of the most common cancers worldwide and it has the highest mortality rate of all gynaecologic cancers. The aim of the study was to examine the impact of several types of nutrition interventions on clinical outcomes in ovarian cancer patients. The study is a systemic review of fourteen randomised controlled trials (RCTs) focusing on nutritional interventions during chemotherapy or during the perioperative period. The majority of RCTs reported improved clinical outcomes after nutritional interventions. Most RCTs show a reduction in length of hospital stay and ameliorated intestinal recovery after surgery. Authors conclude that it is important to find nutritional interventions in order to improve patient’s survival since the ovarian mortality rate is one of the highest among malignancies.

Abstract

undefined: Among all gynaecological neoplasms, ovarian cancer has the highest rate of disease-related malnutrition, representing an important risk factor of postoperative mortality and morbidity. Hence, the importance of finding effective nutritional interventions is crucial to improve ovarian cancer patient's well-being and survival. This systematic review of randomized controlled trials (RCTs) aims at assessing the effects of nutritional interventions on clinical outcomes such as overall survival, progression-free survival, length of hospital stay (LOS), complications following surgery and/or chemotherapy in ovarian cancer patients. Three electronic bibliographic databases (MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials) were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria, until December 2018. A total of 14 studies were identified. Several early postoperative feeding interventions studies ( = 8) were retrieved mainly demonstrating a reduction in LOS and an ameliorated intestinal recovery after surgery. Moreover, innovative nutritional approaches such as chewing gum intervention ( = 1), coffee consumption ( = 1), ketogenic diet intervention ( = 2) or fruit and vegetable juice concentrate supplementation diet ( = 1) and short-term fasting ( = 1) have been shown as valid and well-tolerated nutritional strategies improving clinical outcomes. However, despite an acceptable number of prospective trials, there is still a lack of homogeneous and robust endpoints. In particular, there is an urgent need of RCTs evaluating overall survival and progression-free survival during ovarian oncology treatments. Further high-quality studies are warranted, especially prospective studies and large RCTs, with more homogeneous types of intervention and clinical outcomes, including a more specific sampling of ovarian cancer women, to identify appropriate and effective nutritional strategies for this cancer, which is at high risk of malnutrition.

Lifestyle medicine

Fundamental Clinical Imbalances : Hormonal ; Immune and inflammation
Patient Centred Factors : Triggers/Nutrition interventions
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Not applicable

Methodological quality

Allocation concealment : Not applicable
Publication Type : Journal Article ; Review

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