{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:10Z","timestamp":1790751370426,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malnutrition is prevalent in women with cervical cancer and may be associated with postoperative infectious complications following radical hysterectomy. Evidence specifically evaluating structured multimodal perioperative nutritional\/ERAS care in this population remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a single-center retrospective nonconcurrent cohort study of 268 patients who underwent radical hysterectomy for cervical cancer (FIGO stages IA\u2013IIB) between January 2020 and December 2024. Patients who received a structured multimodal perioperative nutritional\/ERAS care pathway (NSG,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f134) were compared with patients receiving standard care (CG,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f134). Nutritional status was assessed using NRS-2002 and serial albumin, prealbumin, and CRP measurements. The primary outcome was any postoperative infectious complication within 30\u202fdays. Multivariable logistic regression was used to examine associations with infection risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were similar in magnitude for measured variables; however, nonsignificant baseline tests were not interpreted as evidence of equivalence or successful matching. The 30-day infectious complication rate was lower in the NSG than in the CG (18.7% vs. 33.6%; unadjusted RR 0.56, 95% CI 0.36\u20130.85;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.005). SSI was also less frequent (6.0% vs. 14.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.026), whereas the difference in UTI did not reach conventional statistical significance (8.2% vs. 15.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.060). By POD 7, albumin was 39.1\u202f\u00b1\u202f4.0 versus 34.2\u202f\u00b1\u202f4.9\u202fg\/L, and mean LOS was 12.3\u202f\u00b1\u202f4.1 versus 15.8\u202f\u00b1\u202f5.6\u202fdays. In the exploratory multivariable model, pathway exposure was associated with lower adjusted odds of infectious complications (adjusted OR 0.47; 95% CI 0.26\u20130.85;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Receipt of the structured multimodal perioperative nutritional\/ERAS care pathway was associated with lower observed odds of 30-day infectious complications and shorter hospitalization. Because the study used a retrospective nonconcurrent comparison and the intervention was bundled, these findings should not be interpreted as proof that nutritional support alone caused the observed differences. Prospective comparative studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1950549","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:05:42Z","timestamp":1790748342000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of a multimodal perioperative nutritional\/ERAS care pathway with postoperative infectious complications following radical hysterectomy for cervical cancer: a retrospective nonconcurrent cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Keke","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynecology, Jinhua Central Hospital","place":["Jinhua, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Operating Room, Huai'an Hospital of Huai'an City (Huai'an Clinical Medical College of Jiangsu University)","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Nantong Haimen District People's Hospital","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical cancer","volume":"393","author":"Cohen","year":"2019","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1007\/s00404-021-06248-8","article-title":"Perioperative morbidity of different operative approaches in early cervical carcinoma: a systematic review and meta-analysis comparing minimally invasive versus open radical hysterectomy","volume":"306","author":"Kampers","year":"2022","journal-title":"Arch Gynecol Obstet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1136\/ijgc-2019-000356","article-title":"Guidelines for perioperative care in gynecologic\/oncology: enhanced recovery after surgery (ERAS) society recommendations-2019 update","volume":"29","author":"Nelson","year":"2019","journal-title":"Int J Gynecol Cancer"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.ygyno.2023.04.009","article-title":"Enhanced recovery after surgery (ERAS\u00ae) society guidelines for gynecologic oncology: addressing implementation challenges - 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