Nutritional Risk Screening in Gynaecologic Oncology Surgery: Importance, Scoring Systems, Recommendations and Practical Applications

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Abstract
Background/Objectives: Nutritional risk screening is critical in the management of gynaecologic oncology (GO) surgical patients. Malnutrition is prevalent in this population and is associated with poorer surgical outcomes, including increased morbidity, prolonged hospital stays, and reduced survival rates. Nevertheless, the optimal nutritional screening tools for this patient group remain undefined. Methods: We conducted a narrative review to critically appraise commonly used nutritional screening and assessment tools in surgical GO patients. To highlight practical challenges in accurately identifying at-risk individuals, we incorporated findings from our recent clinical audit. Results: Several nutritional screening and assessment tools were identified. The results varied considerably between tools. The presence of ascites and rapid deterioration in oral intake were frequently overlooked, leading to under-recognition of malnutrition. These issues were corroborated by our audit findings. Emerging strategies including determining body composition from routine preoperative CT scans show promise. Conclusions: Accurate nutritional assessment is imperative to improve surgical outcomes in surgical GO patients. As currently no gold standard currently exists for this population, bespoke approaches to address disease-specific nutritional considerations are urgently needed to identify those at risk and allow for timely nutritional interventions. Integrating CT-based body composition analysis can provide an objective solution, thus requiring further investigation.

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