Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study

Pratik Raichurkar¹, Linda Denehy^{2

3}, Michael Solomon^{1

4

5

6}, Cherry Koh^{1

4

5

6}, Neil Pillinger^{1

7}, Sophie Hogan^{4

8}, Kate McBride^{1

4}, Sharon Carey^{1

4

5

8}, Jenna Bartyn¹, Nicholas Hirst¹, Daniel Steffens^{9

10

11}; Prehabilitation Expert Collaborative

Collaborators, Affiliations

Collaborators

Prehabilitation Expert Collaborative:
Jonathan Allen, Kevin Ancog, Eva Angenete, Nabila Ansari, Fabio Ausania, Anna Beaumont, Christian Beilstein, Frederik Berrevoet, Ianthe Boden, Kimberley Bostock, Janine Bothe, Birgitte Brandstrup, Louise Brennan, Kilian Brown, Sorrel Burden, Crystal Burgess, Elaine Burns, Francesco Carli, Vinicius Cavalheri, Wim Ceelen, Tyler Chesney, David Clark, Kari Clifford, Kelcie Cole, Thomas Collyer, Rob Copeland, Roland Croner, Jess Crowe, Ian Daniels, Gerard Danjoux, June Davis, Caitlin Davis, Mayke de Klerk, Tina Decorte, Jan Willem Dekker, Andreas Denys, Liesbeth Desender, Pieter Dries, Declan Dunne, Lara Edbrooke, Linda Edgar, Sabry Eissa, Dominique Engel, Martyn Evans, Rhonda Farrell, Alice Finch, Aisling Fleury, Patrice Forget, Nader Francis, Frank Frizelle, Walter Frontera, Karen Geboes, Hugh Giddings, Chris Gillespie, Chelsia Gillis, Olivier Glehen, Varsha Gorey, Catherine Granger, Diana Greenfield, Ben Griffiths, Chloe Grimmett, Claire Hackett, Travis Hall, Julie Hallet, Craig Harris, Sophie Hatcher, Lizza Hendriks, Mendy Hermans, Carl Ilyas, Hilmy Ismail, John Jenkins, Wilson Jiang, Charlotte Johnstone, Andreas Karakatsanis, Sascha Karunaratne, Simarjit Kaur, Michael Kelly, Joost Klaase, Dorian Kršul, Scott Leslie, Jenelle Loeliger, Marie-Louise Lydrup, Andrea Maier, Piotr Major, Preet Makker, Christopher Mantyh, Stuart McCluskey, Laura McGarrity, Jayson Moloney, Isacco Montroni, Brendan Moran, Paul Morris, Susan Moug, Rajeswari Ms, Sandra Murdoch, Anna Myers, Kheng-Seong Ng, Per J Nilsson, Peter Noordzij, Mike O'Connor, Gianluca Pellino, Shannon Philp, Marc Pocard, Zudin Puthucheary, Emma Putrus, Aaron Quyn, Thomas Read, William Ricketts, Bernhard Riedel, Harm Rutten, Charissa Sabajo, Rawand Salihi, Tarik Sammour, Charbel Sandroussi, Daniel Santa Mina, Stefan Saric, Raquel Sebio, Doruk Seyfi, Favil Singh, Gerrit Slooter, Neil Smart, Lissa Spencer, Paul Sutton, Hao Ern Tan, David Ten Cate, Akif Turna, Elke Van Daele, Adinda van den Berg, Charlotte van Kessel, Gabrielle van Ramshorst, Emiel Verdaasdonk, Jennifer Vu, Chris Wakeman, Malcolm West, James Wheeler, Duminda Wijeysundera, Hideaki Yano

Affiliations

¹ Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
² Department of Health Services Research: Allied Health, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
³ Department of Physiotherapy, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
⁴ Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁵ Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia.
⁶ Colorectal Department, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁷ Department of Anaesthetics, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁸ Nutrition and Dietetics Department, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁹ Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia. Daniel.Steffens@health.nsw.gov.au.
¹⁰ Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia. Daniel.Steffens@health.nsw.gov.au.
¹¹ Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia. Daniel.Steffens@health.nsw.gov.au.

PMID: 37620526
PMCID: PMC10562336
DOI: 10.1245/s10434-023-14192-x

Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study

Pratik Raichurkar et al. Ann Surg Oncol. 2023 Nov.

. 2023 Nov;30(12):7226-7235.

doi: 10.1245/s10434-023-14192-x. Epub 2023 Aug 24.

Authors

Collaborators

Prehabilitation Expert Collaborative:
Jonathan Allen, Kevin Ancog, Eva Angenete, Nabila Ansari, Fabio Ausania, Anna Beaumont, Christian Beilstein, Frederik Berrevoet, Ianthe Boden, Kimberley Bostock, Janine Bothe, Birgitte Brandstrup, Louise Brennan, Kilian Brown, Sorrel Burden, Crystal Burgess, Elaine Burns, Francesco Carli, Vinicius Cavalheri, Wim Ceelen, Tyler Chesney, David Clark, Kari Clifford, Kelcie Cole, Thomas Collyer, Rob Copeland, Roland Croner, Jess Crowe, Ian Daniels, Gerard Danjoux, June Davis, Caitlin Davis, Mayke de Klerk, Tina Decorte, Jan Willem Dekker, Andreas Denys, Liesbeth Desender, Pieter Dries, Declan Dunne, Lara Edbrooke, Linda Edgar, Sabry Eissa, Dominique Engel, Martyn Evans, Rhonda Farrell, Alice Finch, Aisling Fleury, Patrice Forget, Nader Francis, Frank Frizelle, Walter Frontera, Karen Geboes, Hugh Giddings, Chris Gillespie, Chelsia Gillis, Olivier Glehen, Varsha Gorey, Catherine Granger, Diana Greenfield, Ben Griffiths, Chloe Grimmett, Claire Hackett, Travis Hall, Julie Hallet, Craig Harris, Sophie Hatcher, Lizza Hendriks, Mendy Hermans, Carl Ilyas, Hilmy Ismail, John Jenkins, Wilson Jiang, Charlotte Johnstone, Andreas Karakatsanis, Sascha Karunaratne, Simarjit Kaur, Michael Kelly, Joost Klaase, Dorian Kršul, Scott Leslie, Jenelle Loeliger, Marie-Louise Lydrup, Andrea Maier, Piotr Major, Preet Makker, Christopher Mantyh, Stuart McCluskey, Laura McGarrity, Jayson Moloney, Isacco Montroni, Brendan Moran, Paul Morris, Susan Moug, Rajeswari Ms, Sandra Murdoch, Anna Myers, Kheng-Seong Ng, Per J Nilsson, Peter Noordzij, Mike O'Connor, Gianluca Pellino, Shannon Philp, Marc Pocard, Zudin Puthucheary, Emma Putrus, Aaron Quyn, Thomas Read, William Ricketts, Bernhard Riedel, Harm Rutten, Charissa Sabajo, Rawand Salihi, Tarik Sammour, Charbel Sandroussi, Daniel Santa Mina, Stefan Saric, Raquel Sebio, Doruk Seyfi, Favil Singh, Gerrit Slooter, Neil Smart, Lissa Spencer, Paul Sutton, Hao Ern Tan, David Ten Cate, Akif Turna, Elke Van Daele, Adinda van den Berg, Charlotte van Kessel, Gabrielle van Ramshorst, Emiel Verdaasdonk, Jennifer Vu, Chris Wakeman, Malcolm West, James Wheeler, Duminda Wijeysundera, Hideaki Yano

Affiliations

¹ Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
² Department of Health Services Research: Allied Health, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
³ Department of Physiotherapy, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
⁴ Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁵ Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia.
⁶ Colorectal Department, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁷ Department of Anaesthetics, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁸ Nutrition and Dietetics Department, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
⁹ Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia. Daniel.Steffens@health.nsw.gov.au.
¹⁰ Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia. Daniel.Steffens@health.nsw.gov.au.
¹¹ Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia. Daniel.Steffens@health.nsw.gov.au.

PMID: 37620526
PMCID: PMC10562336
DOI: 10.1245/s10434-023-14192-x

Abstract

Background: Recently, the number of prehabilitation trials has increased significantly. The identification of key research priorities is vital in guiding future research directions. Thus, the aim of this collaborative study was to define key research priorities in prehabilitation for patients undergoing cancer surgery.

Methods: The Delphi methodology was implemented over three rounds of surveys distributed to prehabilitation experts from across multiple specialties, tumour streams and countries via a secure online platform. In the first round, participants were asked to provide baseline demographics and to identify five top prehabilitation research priorities. In successive rounds, participants were asked to rank research priorities on a 5-point Likert scale. Consensus was considered if > 70% of participants indicated agreement on each research priority.

Results: A total of 165 prehabilitation experts participated, including medical doctors, physiotherapists, dieticians, nurses, and academics across four continents. The first round identified 446 research priorities, collated within 75 unique research questions. Over two successive rounds, a list of 10 research priorities reached international consensus of importance. These included the efficacy of prehabilitation on varied postoperative outcomes, benefit to specific patient groups, ideal programme composition, cost efficacy, enhancing compliance and adherence, effect during neoadjuvant therapies, and modes of delivery.

Conclusions: This collaborative international study identified the top 10 research priorities in prehabilitation for patients undergoing cancer surgery. The identified priorities inform research strategies, provide future directions for prehabilitation research, support resource allocation and enhance the prehabilitation evidence base in cancer patients undergoing surgery.

Keywords: Cancer; Delphi; Perioperative care; Prehabilitation; Research priorities; Surgery.

PubMed Disclaimer

Conflict of interest statement

Pratik Raichurkar, Linda Denehy, Michael Solomon, Cherry Koh, Neil Pillinger, Sophie Hogan, Kate McBride, Sharon Carey, Jenna Bartyn, Nicholas Hirst and Daniel Steffens have no conflicts of interests to disclose.

Comment in

ASO Author Reflections: Future Directions in Prehabilitation Research.
Raichurkar P, Koh C, Steffens D. Raichurkar P, et al. Ann Surg Oncol. 2023 Dec;30(13):8755-8756. doi: 10.1245/s10434-023-14304-7. Epub 2023 Sep 29. Ann Surg Oncol. 2023. PMID: 37773563 Free PMC article. No abstract available.

References

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Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study

Collaborators

Affiliations

Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Comment in

References

MeSH terms

LinkOut - more resources

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