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

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&a...

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Bibliographic Details
Main Authors: Emanuele Rinninella, Anna Fagotti, Marco Cintoni, Pauline Raoul, Giuseppe Scaletta, Lorena Quagliozzi, Giacinto Abele Donato Miggiano, Giovanni Scambia, Antonio Gasbarrini, Maria Cristina Mele
Format: Article
Language:English
Published: MDPI AG 2019-06-01
Series:Nutrients
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Online Access:https://www.mdpi.com/2072-6643/11/6/1404
Description
Summary: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&#8217;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 (<i>n</i> = 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 (<i>n</i> = 1), coffee consumption (<i>n</i> = 1), ketogenic diet intervention (<i>n</i> = 2) or fruit and vegetable juice concentrate supplementation diet (<i>n</i> = 1) and short-term fasting (<i>n</i> = 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.
ISSN:2072-6643