Implementing a perioperative weight management program for ovarian cancer patients undergoing ultra-radical...

Patients undergoing ultra-radical cytoreductive surgery (CRS) for advanced ovarian cancer are at high risk of postoperative catabolic stress, leading to unintentional weight loss and skeletal muscle depletion. Structured perioperative nutrition and rehabilitation pathways remain insufficiently described in this setting.

To evaluate the association between a multidisciplinary perioperative weight management program and pre-chemotherapy postoperative weight loss, nutritional status, body composition, and treatment-related recovery among patients undergoing ultra-radical CRS for ovarian cancer.

This quasi-experimental quality improvement study included 160 patients undergoing ultra-radical CRS at a tertiary oncology center. Patients treated between January and December 2024 received routine care (control group, n=80), whereas patients treated between April and October 2025 received a structured multidisciplinary intervention (experimental group, n=80). Allocation was based on treatment period rather than randomization. The primary outcome was pre-chemotherapy postoperative weight loss rate. Secondary outcomes included changes in serum albumin levels, body composition parameters, time to initiation of adjuvant chemotherapy, and postoperative length of stay.

The experimental group showed a significantly lower weight loss rate compared with the control group (2.90% vs. 5.31%, P<0.001). The proportion of patients with clinically significant weight loss (>5%) was also significantly lower in the experimental group (31.3% vs. 48.8%, P = 0.024). The decline in serum albumin was significantly attenuated (-4.10 vs. -6.98 g/L, P<0.001). Fat-free mass showed an apparent increase in the experimental group and should be interpreted cautiously because bioelectrical impedance-derived lean-mass estimates may be influenced by perioperative fluid shifts. Skeletal muscle loss was numerically smaller but did not reach two-tailed statistical significance after correction (P = 0.055). Time to initiation of adjuvant chemotherapy was shorter in the experimental group (14.84 vs. 22.03 days, P = 0.002).

A multidisciplinary perioperative weight management program was associated with lower pre-chemotherapy postoperative weight loss, better preservation of selected nutritional indicators, and earlier readiness for adjuvant chemotherapy. Because of the historical-control design, restricted BMI range, and incomplete oncological outcome data, these findings should be interpreted as hypothesis-generating and require confirmation in prospective multicenter studies.