Appetite loss during chemotherapy is associated with reduced dietary intake and quality of life in patients with gynecologic cancer: a prospective observational study

Abstract Purpose Appetite loss is common during chemotherapy. However, its association with dietary intake and quality of life (QOL) in patients with gynecologic cancer remains unclear. This study aimed to clarify the dietary changes associated with appetite loss and investigate their association with QOL and adverse events. Methods Patients with gynecologic cancer receiving chemotherapy were enrolled in this single-center longitudinal observational study. Dietary intake was assessed at baseline and before the third chemotherapy cycle using a diet history questionnaire. Appetite loss, QOL, and adverse events were evaluated using the EORTC QLQ-C30 and PRO-CTCAE. Sensitivity analyses addressed pre-existing appetite loss and postoperative effects. A complementary analysis of a separate cohort examined the association between appetite loss and longitudinal QOL changes. Results Among 105 patients, 41 (39.0%) reported appetite loss before the third chemotherapy cycle. The appetite loss group showed greater reductions in energy and macronutrient intake, whereas macronutrient composition did not differ between the groups. Absolute micronutrient intake broadly decreased, but no difference remained significant after energy adjustment. Among adverse events, taste changes were most closely associated with appetite loss. Appetite loss was also associated with QOL decline, and dietary findings were directionally consistent in sensitivity analyses. The complementary analysis showed appetite loss was consistently associated with QOL fluctuations. Conclusion Appetite loss during chemotherapy was associated with reduced dietary intake and lower QOL. Taste alterations were closely associated with appetite loss. These findings support appetite loss as a clinically relevant target for the supportive care of patients with gynecologic cancers.