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Adjuvant therapy of surgical menopause symptoms in rehabilitation of patients with borderline ovarian tumors: a role of “cancer immunotherapy diet”

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Aim: to examine intensity of surgical menopause symptoms (postovariectomy syndrome, POES) in patients with borderline ovarian tumors (BOTs) after radical surgery depending on the postoperative period management; to assess a role for “cancer immunotherapy diet”* as a standalone means in correction of surgical menopause symptoms as well as a part of patient-specific rehabilitation program.

Materials and Methods. A prospective comparative study was conducted with 62 BOTs female patients aged 30 to 48 (42.0 ± 4.1) years underwent radical surgical treatment, subdivided into 3 groups: group I – “active” rehabilitation (29 subjects underwent 12 month-comprehensive personalized rehabilitation); group II – “passive” rehabilitation (17 women with standard management of the postoperative period in accordance with clinical recommendations); group III – 16 patients followed the one-year “cancer immunotherapy diet” (after being consulted by medical specialist and formulation of individual diet program). Patient data obtained after clinical interview, physical, laboratory and instrumental examinations were assessed at four time points: before surgery (visit 0), after 1, 6 and 12 months (visits 1, 2, 3) after antitumor treatment. In addition, every visit required each patient to fill out the modified Kupperman menopausal index (MMI) questionnaire specifically adapted for BOTs patients. Intensity of neurovegetative, psycho-emotional and metabolic manifestations of surgical menopause symptoms was assessed at various stages of post-surgery period and management strategy during post-surgery period.

Results. All BOTs patients one month after radical surgical treatment noted overt signs of surgical menopause. Before surgery, the average MMI score corresponded to normal range – 10.9 (group I), 10.5 (group II), 10.4 (group III), whereas during visit 1 it changed to 37.1, 35.2 and 36.4, respectively evidencing about moderate severity of POES. MMI largely depended on management strategy 6 and 12 months after the onset of therapy: in “active” rehabilitation group it was 27.7 (visit 2) and 22.2 (visit 3), “passive” rehabilitation group – 39.1 (visit 2) and 42.6 (visit 3), “cancer immunotherapy diet” group – 34.1 (visit 2) and 30.8 (visit 3). In addition, distribution of patients based on body mass index (BMI) revealed various types of impaired fat metabolism (IFM) in 59.68 % subjects at visit 0, that increased one month after surgery up to 64.52 %, whereas 6 and 12 months later it decreased down to 62.90 and 61.29 %, respectively. However, end-point results in different groups varied substantially: In particular, at visit 3 in group I 55.17 % (n = 16) subjects had normal BMI, 37.93 % (n = 11) – class I obesity and 6.90 % (n = 2) – class II obesity. The end-point results in group II revealed no patients with normal BMI: 76.47 % (n = 13) and 23.53 % (n = 4) had class I and class II obesity, respectively. Finally, end-point results in group III were at intermediate state: 50.0 % (n = 8) subjects showed normal BMI, whereas 37.5 % (n = 6) and 12.5 % (n = 2) patients demonstrated class I and class II obesity, respectively.

Conclusion. Adjuvant therapy of surgical menopause symptoms represents an important component in rehabilitation program for BOTs patients underwent radical surgery. A personalized rehabilitation program demonstrates peak efficacy in correcting surgical menopause symptoms (essential to include “cancer immunotherapy diet” therein). Even isolated administration of diet therapy profoundly reduces intensity of surgical menopause symptoms, thereby improving the quality of woman’s life.

About the Authors

A. G. Solopova
Department of Obstetrics and Gynecology, N. F. Filatov Clinical Institute of Children’s Health, Sechenov University
Russian Federation

Antonina G. Solopova - MD, Dr Sci Med, Professor

62 Str. Zemlyanoi Val., Moscow 109004

Scopus Author ID: 6505479504

Researcher ID: Q-1385-2015

A. Yu. Vlasina
Department of Obstetrics and Gynecology, N. F. Filatov Clinical Institute of Children’s Health, Sechenov University
Russian Federation

Anastasiya Yu. Vlasina - MD, Postgraduate Student

62 Str. Zemlyanoi Val., Moscow 109004

Scopus Author ID: 1016902

Researcher ID: AAF-3130-2020

E. A. Son
Department of Faculty Therapy № 1, N. V. Sklifosovsky Institute of Clinical Medicine, Sechenov University
Russian Federation

Elena A. Son - MD, PhD, Associate Professor

6 buil. 1, Bolshaya Pirogovskaya Str., Moscow 119435

Scopus Author ID: 19837664400

A. E. Ivanov
City Clinical Oncology Hospital № 1, Moscow Healthcare Department
Russian Federation

Alexander E. Ivanov - MD, PhD

17/1 Baumanskaya Str., Moscow 105005

E. A. Ivanova
Department of Obstetrics and Gynecology, N. F. Filatov Clinical Institute of Children’s Health, Sechenov University
Russian Federation

Evgeniya A. Ivanova - 6th year Student

62 Str. Zemlyanoi Val., Moscow 109004


1. Kurman R. J., Carcangiu M., Herrington C. S. et al. WHO classification of tumours of female reproductive organs. 4th ed. Lyon: International Agency for Research on Cancer, 2014. 307 p.

2. Solopova A. G., Vlasina A. Yu., Makatsariya N. A. et al. To the issue of borderline ovarian tumors. [K voprosu o pogranichnyh opuholyah yaichnikov]. Akusherstvo, Ginekologia i Reprodukcia. 2018;12(3):64– 71. (In Russ.).

3. Crane E. K., Thaker P. H. Borderline tumors of the ovary. In: Textbook of uncommon cancer. Eds. D. Raghavan, M. S. Ahluwalia, Ch.D. Blanke et al. 5th ed. Wiley Blackwel, 2017. 572–81.

4. Solopova A. E., Makatsariya A. D., Sdvizhkov A. M., Ternovoy S. K. Magnetic resonance imaging in the differential diagnosis of ovarian masses: Capabilities of quantitative multiparametric evaluation. [Magnitno-rezonansnaya tomografiya v differencial’noj diagnostike obrazovanij yaichnika. Vozmozhnosti kolichestvennoj mul’tiparametricheskoj ocenki]. Akusherstvo i ginekologiya. 2017;(2):80–5. (In Russ.).

5. Plett H., Harter P., Ataseven B. et al. Fertility-sparing surgery and reproductive-outcomes in patients with borderline ovarian tumors. Gynecol Oncol. 2020 Feb 27. pii: S0090-8258(20)30102-5. [Epub ahead of print].

6. Rodríguez M., Shoupe D. Surgical menopause. Endocrinol Metab Clin North Am. 2015;44(3):531–42.

7. Secoşan C., Balint O., Pirtea L. et al. Surgically induced menopause – a practical review of literature. Medicina (Kaunas). 2019;55(8). pii: E482.

8. Vlasina A. V., Idrisova L. E., Solopova A. G. et al. Rehabilitation of oncogynecological patients after antitumor therapy: ways of solution. [Reabilitaciya onkoginekologicheskih bol’nyh posle protivoopuholevoj terapii: puti resheniya]. Akusherstvo, Ginekologia i Reprodukcia. 2020;14(1):44–55. (In Russ.).

9. Gröber U., Holzhauer P., Kisters K. et al. Micronutrients in oncological intervention. Nutrients. 2016;8(3):163.

10. Kumar B. S., Singh S., Verma R. Anticancer potential of dietary vitamin D and ascorbic acid: A review. Crit Rev Food Sci Nutr. 2017;57(12):2623– 35.

11. Singh M. Metabolic interactions between various micronutrients. Indian J Pediatr. 2016;83:279–80.

12. Vlasina A., Solopova A., Ivanova E. et al. Anticancer diet, or principles of rational nutrition in gynecological cancer patients during rehabilitation. [«Protivorakovaya dieta», ili principy racional’nogo pitaniya onkoginekologicheskih bol’nyh v period reabilitacii]. Vrach. 2020;31(4):3–7. (In Russ.).

13. Koutoukidis D. A., Beeken R. J., Lopes S. et al. Attitudes, challenges and needs about diet and physical activity in endometrial cancer survivors: a qualitative study. Eur J Cancer Care. 2016;26(6):e12531.

14. Chan D. S., Vieira A. R., Aune D. et al. Body mass index and survival in women with breast cancer-systematic literature review and metaanalysis of 82 follow-up studies. Ann Oncol. 2014;25(10):1901–14.

15. Gnagnarella P., Dragà D., Baggi F. et al. Promoting weight loss through diet and exercise in overweight or obese breast cancer survivors (InForma): study protocol for a randomized controlled trial. Trials. 2016;17:363.

16. Smits A., Lopes A., Das N. et al. The effect of lifestyle interventions on the quality of life of gynaecological cancer survivors. Gynecol Oncol. 2015;139(3):546–52.

17. Koshimoto S., Arimoto M., Saitou K. et al. Need and demand for nutritional counselling and their association with quality of life, nutritional status and eating-related distress among patients with cancer receiving outpatient chemotherapy: a cross-sectional study. Support Care Cancer. 2019;27(9):3385–94.

18. Farahmand M., Ramezani Tehrani F., Bahri Khomami M. et al. Surgical menopause versus natural menopause and cardio-metabolic disturbances: A 12-year population-based cohort study. J Endocrinol Invest. 2015;38(7):761–7.

19. Cripe J. C., Buchanan T. R., Kuroki L. M. et al. Association between body mass index and surgical menopausal symptoms in patients with early stage endometrial cancer. Gynecol Oncol. 2019;153(1):123–6.

20. Cho N. Y., Kim S., Nowakowski S. et al. Sleep disturbance in women who undergo surgical menopause compared with women who experience natural menopause. Menopause. 2019;26(4):357–64.

For citation:

Solopova A.G., Vlasina A.Yu., Son E.A., Ivanov A.E., Ivanova E.A. Adjuvant therapy of surgical menopause symptoms in rehabilitation of patients with borderline ovarian tumors: a role of “cancer immunotherapy diet”. Obstetrics, Gynecology and Reproduction. 2020;14(3):296-313. (In Russ.)

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