Implementing a perioperative weight management program for ovarian cancer patients undergoing ultra-radical cytoreduction: a quality improvement initiative

Background: 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. Objective: 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. Methods: 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. Results: The experimental group showed a significantly lower weight loss rate compared with the control group (2.90% vs. 5.31%, P5%) 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