Archives of Gynecology and Obstetrics

, Volume 297, Issue 6, pp 1533–1538 | Cite as

Peri-operative oral immunonutrition in malnourished ovarian cancer patients assessed by the nutritional risk screening

  • Linda Hertlein
  • Christine Zeder-Göß
  • Sophie Fürst
  • Daniela Bayer
  • Fabian Trillsch
  • Bastian Czogalla
  • Sven Mahner
  • Alexander Burges
  • Peter Rittler
Gynecologic Oncology



Aim of this study was to determine whether peri-operative immunonutrition can decrease complications and the length of stay (LOS) in malnourished ovarian cancer patients.

Study design

Patients suspicious for advanced ovarian cancer before histopathological diagnosis and a nutritional risk score (NRS) ≥ 3 received oral immune-modulating diets (IMDs) for 5 days pre-operative and at least 5 days post-operative. Parameters for clinical outcome were infectious and non-infectious complications during hospital stay, and time of hospitalization. The results were compared with malnourished ovarian cancer patients of a previous study without any additive nutritional support (standard clinical diet/nutrition).


The infectious and non-infectious complication rate in the interventional group (IG) N = 28 was 42.9%, similar to the control group (CG) N = 19 with 42.1%, whereas the rate of infectious complications in the IG (21.4%) was slightly lower compared to the CG (26.3%). The median LOS of the IG was 18 days, and therefore, longer than LOS of the CG (15 days). Regarding the patients’ compliance pre-operative 78.6% of the patients took the IMDs in an optimal and sufficient amount. Whereas after surgery, only eight (28.6%) patients were able to take IMDs in optimal and sufficient amount.


The current study showed no improvement of the complication rate or the time of hospitalization due to additional peri-operative immunonutrition in malnourished ovarian cancer patients. However, a trend towards the reduction of infectious complications could be seen in the IG.


Immunonutrition Malnutrition NRS score Ovarian cancer 



Nutritional risk screening


Immune-modulating diets


Body mass index




Length of stay


Interventional group


Control group



We thank Anna Müller for support in patients’ recruitment. In addition, we thank Andrea Malota, MD for language revision.

Author contributions

LH: Protocol development, Data collection, Data analysis. Manuscript writing: CZ-G: Data collection; SF: Data collection. DB: Data collection; FT: Data analysis. BC: Data analysis; SM: Manuscript editing. AB: Protocol development, Data collection. PR: Protocol development, Data analysis, Manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, University HospitalLMU MunichMunichGermany
  2. 2.Surgical Department, University HospitalLMU MunichMunichGermany

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