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. 2022 Mar 23;14(7):1635.
doi: 10.3390/cancers14071635.

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

Berta Diaz-Feijoo  1 , Nuria Agusti-Garcia  1 , Raquel Sebio  2 , Antonio López-Hernández  3 , Marina Sisó  4 , Ariel Glickman  1 , Nuria Carreras-Dieguez  1 , Pere Fuste  1 , Tiermes Marina  1 , Judit Martínez-Egea  1 , Laura Aguilera  1 , Juan Perdomo  3 , Amaia Pelaez  3 , Manuel López-Baamonde  3 , Ricard Navarro-Ripoll  3 , Elena Gimeno  2 , Betina Campero  4 , Aureli Torné  1 , Graciela Martinez-Palli  3   5 , María J Arguis  3
Affiliations

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

Berta Diaz-Feijoo et al. Cancers (Basel). .

Abstract

Introduction: 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.

Methods: 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.

Results: 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, p = 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, p = 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, p = 0.03).

Conclusions: 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.

Keywords: Enhanced Recovery After Surgery; advanced ovarian cancer; comprehensive complications index; length of stay; multimodal prehabilitation; surgical complications.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram showing the timing of patient assessments and interventions in the prehabilitation cohort.
See this image and copyright information in PMC

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