Relationship between nutritional status and health-related quality of life in patients receiving chemotherapy after radical ovarian cancer surgery: a cross-sectional study

Objective: To investigate the nutritional status and health-related quality of life (HRQoL) of postoperative chemotherapy patients with ovarian cancer and to discuss the relationship between these patients’ nutritional status and HRQoL. Methods: 201 postoperative chemotherapy patients with ovarian cancer were enrolled. All of them were assessed with a general information questionnaire, the Patient Generated-Subjective Global Assessment (PG-SGA), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). We compared the nutritional status and HRQoL among patients with different demographics and disease characteristics, as well as analyzed the correlations between nutritional status and HRQoL. Results: The mean quantitative evaluation of PG-SGA in patients receiving postoperative chemotherapy for ovarian cancer was 7.82 ±$\pm$ 4.58. Almost all of the study subjects in this investigation were moderately or severely malnourished and required nutritional support. We established a multivariate linear regression equation and found that the total PG-SGA score is an important predictor of HRQoL in postoperative chemotherapy patients with ovarian cancer. Conclusions: Medical staff can improve the HRQoL of this patient population by improving their nutritional status, thereby enhancing their clinical outcome.

Ovarian cancer; Quality of life; Nutritional status

[1] Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA: A Cancer Journal for Clinicians. 2015; 65: 87–108.

[2] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA: A Cancer Journal for Clinicians. 2020; 70: 7–30.

[3] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA: A Cancer Journal for Clinicians. 2015; 65: 5–29.

[4] Ahmed N, Greening D, Samardzija C, Escalona RM, Chen M, Findlay JK, et al. Unique proteome signature of post-chemotherapy ovarian cancer ascites-derived tumor cells. Scientific Reports. 2016; 6: 30061.

[5] Fromme EK, Eilers KM, Mori M, Hsieh Y, Beer TM. How accurate is clinician reporting of chemotherapy adverse effects? A comparison with patient-reported symptoms from the Quality-of-Life Questionnaire C30. Journal of Clinical Oncology. 2004; 22: 3485–3490.

[6] US Department of Health and Human Services (US-DHHS). Guidance for industry. Patient-reported out-come measures: use in medical product develop-ment to support labeling claims. 2009. Available at: https://www.fda.gov/regulatory-information/search-fda-g uidance-documents/patient-reported-outcome-measures-u se-medical-product-development-support-labeling-claims (Accessed: 1 October 2021).

[7] Kostka J, Borowiak E, Kostka T. Nutritional status and quality of life in different populations of older people in Poland. European Journal of Clinical Nutrition. 2014; 68: 1210–1215.

[8] Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A. Quality of life of patients with lung cancer. OncoTargets and Therapy. 2016; 9: 1023–1028.

[9] Ottery FD. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Seminars in Oncology. 1994; 21: 770–778.

[10] Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. European Journal of Clinical Nutrition. 2002; 56: 779–785.

[11] Laky B, Janda M, Cleghorn G, Obermair A. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients. The American Journal of Clinical Nutrition. 2008; 87: 1678–1685.

[12] Gupta D, Vashi PG, Lammersfeld CA, Braun DP. Role of nutritional status in predicting the length of stay in cancer: a systematic review of the epidemiological literature. Annals of Nutrition and Metabolism. 2011; 59: 96–106.

[13] Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. European Journal of Clinical Nutrition. 2002; 56: 779–785.

[14] Isenring E, Bauer J, Capra S. The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. European Journal of Clinical Nutrition. 2003; 57: 305–309.

[15] Olschewski M, Schulgen G, Schumacher M, Altman DG. Quality of life assessment in clinical cancer research. British Journal of Cancer. 1994; 70: 1–5.

[16] Qin N, Jiang G, Zhang X, Sun D, Liu M. The Effect of Nutrition Intervention With Oral Nutritional Supplements on Ovarian Cancer Patients Undergoing Chemotherapy. Frontiers in Nutrition. 2021; 8: 685967.

[17] Najafi S, Haghighat S, Raji Lahiji M, RazmPoosh E, Chamari M, Abdollahi R, et al. Randomized Study of the Effect of Dietary Counseling during Adjuvant Chemotherapy on Chemotherapy Induced Nausea and Vomiting, and Quality of Life in Patients with Breast Cancer. Nutrition and Cancer. 2019; 71: 575–584.

[18] Thoresen L, Fjeldstad I, Krogstad K, Kaasa S, Falkmer UG. Nutritional status of patients with advanced cancer: the value of using the subjective global assessment of nutritional status as a screening tool. Palliative Medicine. 2002; 16: 33–42.

[19] Soeters PB, Reijven PLM, van Bokhorstde van der Schueren MAE, Schols JMGA, Halfens RJG, Meijers JMM, et al. A rational approach to nutritional assessment. Clinical Nutrition. 2008; 27: 706–716.

[20] Steiger E, Oram-Smith J, Miller E, Kuo L, Vars HM. Effects of nutrition on tumor growth and tolerance to chemotherapy. The Journal of Surgical Research. 1975; 18: 455–466.

[21] Laky B, Janda M, Bauer J, Vavra C, Cleghorn G, Obermair A. Malnutrition among gynaecological cancer patients. European Journal of Clinical Nutrition. 2007; 61: 642–646.

[22] Chantragawee C, Achariyapota V. Utilization of a Scored Patient-Generated Subjective Global Assessment in Detecting a Malnourished Status in Gynecologic Cancer Patients. Asian Pacific Journal of Cancer Prevention. 2016; 17: 4401–4404.

[23] Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME. Cancer: disease and nutrition are key determinants of patients’ quality of life. Supportive Care in Cancer. 2004; 12: 246–252.

[24] Lutgendorf SK, Anderson B, Ullrich P, Johnsen EL, Buller RE, Sood AK, et al. Quality of life and mood in women with gynecologic cancer: a one year prospective study. Cancer. 2002; 94: 131–140.

[25] Richardson A. Measuring fatigue in patients with cancer. Supportive Care in Cancer. 1998; 6: 94–100.

[26] van den Beuken-van Everdingen MHJ, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Annals of Oncology. 2007; 18: 1437–1449.

[27] Mock V, Atkinson A, Barsevick AM, Berger AM, Cimprich B, Eisenberger MA, et al. Cancer-related fatigue. Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network. 2007; 5: 1054–1078.