Feasibility of a Multimodal Prehabilitation Programme in Patients Undergoing Cytoreductive Surgery for Advanced Ovarian Cancer: A Pilot Study

• Published in: Cancers Vol. 14; no. 7; p. 1635
• Main Authors: Diaz-Feijoo, Berta, Agusti-Garcia, Nuria, Sebio, Raquel, López-Hernández, Antonio, Sisó, Marina, Glickman, Ariel, Carreras-Dieguez, Nuria, Fuste, Pere, Marina, Tiermes, Martínez-Egea, Judit, Aguilera, Laura, Perdomo, Juan, Pelaez, Amaia, López-Baamonde, Manuel, Navarro-Ripoll, Ricard, Gimeno, Elena, Campero, Betina, Torné, Aureli, Martinez-Palli, Graciela, Arguis, María J
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 23.03.2022; MDPI
• Subjects: Cancer therapies; Chemotherapy; Comorbidity; Complications; Dietitians; Exercise; Fitness training programs; Gynecological surgery; Gynecology; Intervention; Malnutrition; Nutritional status; Ovarian cancer; Patients; Physical fitness; Physical training; Postoperative; Proteins; Psychologists; Recovery (Medical); Side effects; Sports training; Strength training; Surgery; comprehensive complications index; length of stay; surgical complications; Enhanced Recovery After Surgery; multimodal prehabilitation; advanced ovarian cancer
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers14071635

Treatment for advanced ovarian cancer (AOC) comprises cytoreductive surgery combined with chemotherapy. Multimodal prehabilitation programmes before surgery have demonstrated efficacy in postoperative outcomes in non-gynaecological surgeries. However, the viability and effects of these programmes on patients with AOC are unknown. We aimed to evaluate the feasibility and postoperative impact of a multimodal prehabilitation programme in AOC patients undergoing surgery. This single-centre, before-and-after intervention pilot study included 34 patients in two cohorts: the prehabilitation cohort prospectively included 15 patients receiving supervised exercise, nutritional optimisation, and psychological preparation from December 2019 to January 2021; the control cohort included 19 consecutive patients between January 2018 and November 2019. Enhanced Recovery After Surgery guidelines were followed. The overall adherence to the multimodal prehabilitation programme was 80%, with 86.7% adherence to exercise training, 100% adherence to nutritional optimisation, and 80% adherence to psychological preparation. The median hospital stay was shorter in the prehabilitation cohort (5 (IQR, 4-6) vs. 7 days (IQR, 5-9) in the control cohort, = 0.04). Differences in postoperative complications using the comprehensive complication index (CCI) were not significant (CCI score: 9.3 (SD 12.12) in the prehabilitation cohort vs. 16.61 (SD 16.89) in the control cohort, = 0.08). The median time to starting chemotherapy was shorter in the prehabilitation cohort (25 (IQR, 23-25) vs. 35 days (IQR, 28-45) in the control cohort, = 0.03). A multimodal prehabilitation programme before cytoreductive surgery is feasible in AOC patients with no major adverse effects, and results in significantly shorter hospital stays and time to starting chemotherapy.