title: Impact of improved nutritional status on survival in ovarian cancer.
abstract: OBJECTIVE
  Malnutrition is a common occurrence in ovarian cancer and is a major cause of morbidity and mortality. We evaluated the impact of improvement in nutritional status on ovarian cancer survival.
  
  
  METHODS
  A retrospective chart review was performed on a case series of 98 ovarian cancer patients. Subjective global assessment (SGA) was used to evaluate nutritional status. Patients were classified as well-nourished (SGA A) or moderately-severely malnourished (SGA B/C). Patients were classified into four groups: (1) well-nourished at baseline and 3 months, (2) malnourished at baseline, well-nourished at 3 months, (3) malnourished at baseline and 3 months, (4) well-nourished at baseline, malnourished at 3 months.
  
  
  RESULTS
  Of 98 patients, 20 were newly diagnosed while 78 had received prior treatment. The median age at presentation was 55.3 years. At baseline, the median survival for SGA A (N=46) was 20.3 months while for SGA B/C (N=52) was 9.8 months (p=0.03). At 3 months, the median survival for SGA A (N=63) was 19.9 months while for SGA B/C (N=35) was 3.7 months (p<0.001). Patients with an improved nutritional status at 3 months had a significantly better survival than those with deteriorated nutritional status independent of age, stage at diagnosis, prior treatment history, and tumor response as determined by CA125.
  
  
  CONCLUSIONS
  Improvement in nutritional status is associated with better survival. Consequently, our findings lend support to the importance of aggressive nutritional intervention in improving patient outcomes in oncology.
authors.affiliation: Office of Research, Cancer Treatment Centers of America at Midwestern Regional Medical Center, 2610 Sheridan Road, Zion, IL 60099, USA.
authors.forename: Digant
authors.initials: D
authors.lastname: Gupta
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Lis
authors.forename: Pankaj G
authors.initials: PG
authors.lastname: Vashi
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Lammersfeld
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D015984:Causality; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D044342:Malnutrition / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control*; D008408:Mastectomy; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009752:Nutritional Status; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen