Preoperative nutritional risk and clinically relevant postoperative complications in ovarian cancer patients...

Nutritional risk may affect tolerance to cytoreductive surgery in ovarian cancer. This study evaluated whether preoperative Nutritional Risk Screening 2002 (NRS-2002) score ≥3 was associated with clinically relevant postoperative complications.

This multicenter retrospective cohort study included patients with histologically confirmed ovarian cancer who underwent primary or interval cytoreductive surgery at three tertiary hospitals from January 2021 to December 2024. The primary outcome was Clavien-Dindo grade ≥ II complications during the index hospitalization. Logistic regression was used to identify factors associated with postoperative complications.

Among 867 patients, 253 (29.2%) had NRS-2002 ≥ 3. Clavien-Dindo grade ≥ II complications occurred in 156 patients (18.0%) and were more frequent in patients with NRS-2002 ≥ 3 than in those with NRS-2002 < 3 (24.5% vs. 15.3%, p = 0.001). After adjustment for clinicopathologic, laboratory, and surgical factors, NRS-2002 ≥ 3 was associated with increased odds of complications (adjusted OR 1.661, 95% CI 1.087-2.538, p = 0.019). Lower albumin, higher creatinine, greater intraoperative blood loss, menopausal status, and omental metastasis were also associated with complications.

Preoperative NRS-2002 score ≥3 was independently associated with Clavien-Dindo grade ≥ II postoperative complications after cytoreductive surgery for ovarian cancer. These findings suggest that NRS-2002 may serve as a simple preoperative screening tool to identify patients who may warrant closer perioperative monitoring and further nutritional assessment.Prospective studies are needed to evaluate whether NRS-2002-guided optimization improves surgical outcomes.