Association between nutritional status and chemotherapy interruption in outpatients with ovarian cancer

Background and objectives: Discontinuation of cancer chemotherapy has been reported to worsen the prognosis of patients. However, few studies have examined the role of nutritional status before the start of treatment in chemotherapy interruption. The aim of this study was to determine the relationship between nutritional status at the start of chemotherapy and chemotherapy discontinuation in ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Methods: This was a retrospective case-control study. One hundred and forty-six patients with ovarian cancer, fallopian tube cancer, or primary peritoneal cancer were enrolled. They underwent postoperative chemotherapy as weekly Carboplatin and Paclitaxel therapy at the outpatient chemotherapy center of hospital X between April 2016 and March 2020. Patients were classified into two groups according to whether they had completed chemotherapy or not. Baseline characteristics and nutritional indicators were compared between the groups. Nutritional indicators included serum albumin level (ALB) and Prognostic Nutritional Index (PNI). In addition, the patients were divided into two groups according to ALB (cut off 3.1 g/dl) or PNI (cut off 50.1). The two groups were compared in terms of the number of times they received chemotherapy. Analysis was performed with JMP Pro 15 with statistical significance level of p< 0.05. This study was conducted with the approval of the Ethics Committee of Graduate School of Medicine, Chiba University. ALB and PNI were significantly higher and age was significantly lower in the completed group than in the incomplete group. The times of chemotherapy conducted was significantly lower in the low ALB group than in the non-low ALB group. Similarly, the times of chemotherapy conducted in the low-PNI group was significantly lower than that in the non-low-PNI group. Results: ALB and PNI were significantly higher and age was significantly lower in the completed group than in the incomplete group. The times of chemotherapy conducted was significantly lower in the low ALB group than in the non-low ALB group. Similarly, the times of chemotherapy conducted in the low-PNI group was significantly lower than that in the non-low-PNI group. Conclusions: ALB and PNI were associated with chemotherapy interruption and the times of chemotherapy which patients can be accepted. These results suggested that low nutritional status may play a role in chemotherapy discontinuation.