Aims: Due to advanced-stage diagnosis with gastrointestinal involvement and intensive treatment schedules, women with ovarian cancer are at high risk of malnutrition and aberrations in body composition. This study aimed to investigate access to dietetic care for women with altered body composition during treatment.
Methods: A single-centre retrospective study of 99 women diagnosed with epithelial ovarian cancer between August 2020 and March 2024, was undertaken. Sociodemographic and clinical details were extracted from medical records. Records were reviewed for occurrence and outcome of the Malnutrition Screening Tool (MST), and referral for dietetic intervention following screening or by any other pathway. Body composition (low skeletal muscle index [SMI], low skeletal muscle density [SMD], high total adipose tissue [TATI]) were assessed from pretreatment Computed Tomography images using predefined cut-points.
Results: Participant mean age was 62 (12.7) and 80% had advanced-stage cancer (III/IV). At diagnosis, 67 (67%) women had low SMI, 57 (57%) low SMD, 37 (37%) both low SMI and low SMD, and 23 (23%) both low SMI and high TATI. Despite a high screening occurrence, only 31 (46%) women with low SMI, 30 (53%) with low SMD, 20 (54%) with low SMI and SMD, 11 (48%) with low SMI and high TATI were identified as at risk of malnutrition (MST score > 2). Referral for dietetic assessment often occurred outside of the screening pathway by medical professionals. Overall, 18 (27%) women with low SMI, 15 (26%) with low SMD, 8 (22%) with both low SMI and SMD, and 6 (26%) with both low SMI and high TATI did not receive a referral for dietetic care during treatment.
Conclusions: A quarter of women with altered body composition are not receiving appropriate nutrition care during treatment. Body composition is a modifiable risk factor; however, its prognostic potential hinges on early identification and intervention.