OVARIAN-CANCER CACHEXIA - SURGICAL INTERACTIONS

The woman with advanced ovarian carcinoma presents unusual risks for complications of cancer therapy. The combined effects of mechanical disruption of gastrointestinal function and the metabolic demand of large tumor burden can produce severe nutritional depletion. The additional stress of extensive surgery may exceed the capacity of the host to meet demands for wound healing and control of infection. Isotonic dextrose infusion inhibits the physiologic adaptation of the host to surgical injury and contributes to postoperative morbidity. Fourteen patients with advanced ovarian carcinoma at high risk for postoperative complications received total parenteral nutrition with hypertonic glucose and essential amino acids. Their hospital course compares favorably with that of two other groups receiving isotonic glucose-11 retrospective high-risk controls and 3 concurrent low-risk patients. We conclude that total parenteral nutrition is a safe and cost-effective means of reducing morbidity and mortality after extensive surgery for selected, high-risk patients with Stage III or IV ovarian carcinoma. © 1979.