{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T02:04:34Z","timestamp":1774922674874,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Laboratory of Human Physiology, Department of Nutritional Sciences and Dietetics, International Hellenic University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Although appetite and its disorders have been implicated in disease progression and outcomes, ghrelin concentrations, an objective appetite measure, are rarely assessed in patients with gynecological malignancies. The present study aimed to assess changes in post-operative versus pre-operative appetite levels in patients with gynecological cancers scheduled for tumor removal surgery (N = 53). Acylated ghrelin concentrations were assessed as an objective appetite proxy, whereas the Council of Nutrition appetite questionnaire (CNAQ) was employed as a subjective appetite measure. Ghrelin concentrations were increased post-operatively (median: 12.1 pg\/mL, IQR: 0.67 to 23.5, p-value = 0.001) but the perceived appetite of patients (CNAQ) remained unchanged (median: \u22121, IQR: \u22123 to 1). Tumor removal surgery decreased all anthropometric indices (body weight, body mass index, waist and hips circumferences, triceps skinfolds, body fat, fat mass and fat mass index, p-value \u2264 0.001 for all) and doubled the risk of malnutrition among patients. No difference was recorded in the change in participants\u2019 objective and subjective appetite when they were classified according to the tumor type. No correlation was observed between ghrelin concentrations and CNAQ score pre-operatively (Spearman\u2019s rho correlation coefficient = \u22120.181, p-value = 0.298) or post-operatively (Spearman\u2019s rho correlation coefficient = 0.071, p-value = 0.684). The observed post-operative rise in ghrelin concentrations is associated with body weight loss and consists of a possible defense mechanism of the human body, aiming to prolong survival.<\/jats:p>","DOI":"10.3390\/ijerph191610322","type":"journal-article","created":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T22:23:13Z","timestamp":1661120593000},"page":"10322","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Objective and Subjective Appetite Assessment in Patients with Gynecological Cancer: A Pre- and Post-Operative Pilot Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Iro-Spyridoula","family":"Gounitsioti","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences & Dietetics, Alexander Campus, International Hellenic University, Sindos, GR-57400 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4868-9620","authenticated-orcid":false,"given":"Dimitrios","family":"Poulimeneas","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences & Dietetics, Alexander Campus, International Hellenic University, Sindos, GR-57400 Thessaloniki, Greece"},{"name":"Department of Nutrition and Dietetics, Harokopio University, E. Venizelou 70, GR-17671 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-6595","authenticated-orcid":false,"given":"Maria G.","family":"Grammatikopoulou","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8804-239X","authenticated-orcid":false,"given":"Charalambos","family":"Kotzamanidis","sequence":"additional","affiliation":[{"name":"Hellenic Agricultural Organization-DEMETER, Veterinary Research Institute of Thessaloniki, Thermi Campus, GR-57001 Thermi, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6407-8494","authenticated-orcid":false,"given":"Konstantinos","family":"Gkiouras","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3865-6833","authenticated-orcid":false,"given":"Meletios P.","family":"Nigdelis","sequence":"additional","affiliation":[{"name":"Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Tsolakidis","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexios","family":"Papanikolaou","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, Hippokration General Hospital, 49 Konstantinoupoleos Str., Aristotle University of Thessaloniki, GR-54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basil C.","family":"Tarlatzis","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9697-7902","authenticated-orcid":false,"given":"Dimitrios P.","family":"Bogdanos","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Tsigga","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences & Dietetics, Alexander Campus, International Hellenic University, Sindos, GR-57400 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5005-1995","authenticated-orcid":false,"given":"Dimitrios G.","family":"Goulis","sequence":"additional","affiliation":[{"name":"Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/jamaoncol.2019.2996","article-title":"Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017","volume":"5","author":"Fitzmaurice","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3802\/jgo.2011.22.2.103","article-title":"Quality of life in gynecologic cancer survivors compared to healthy check-up women","volume":"22","author":"Wilailak","year":"2011","journal-title":"J. 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