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. 2025 Jun 4;40(6):ivaf107.
doi: 10.1093/icvts/ivaf107.

Impact of a hybrid, short-term prehabilitation on patient-reported outcomes in patients undergoing lung resection for non-small cell lung cancer

Alice Finch  1 , Jordan Curry  2 , Gowthanan Santhirakumaran  3 , Saif Alshdifat  3 , Jack Jones  1 , Duncan Grant  1 , Riley Cooper  1 , Anthony Assadourian  1 , Adam Januszewski  4 , Sahra Jalali  1 , Kelvin Lau  3 , William Ricketts  5 , Cecilia Pompili  3   6
Affiliations

Impact of a hybrid, short-term prehabilitation on patient-reported outcomes in patients undergoing lung resection for non-small cell lung cancer

Alice Finch et al. Interdiscip Cardiovasc Thorac Surg. .

Abstract

Objectives: We examined the impact of short-term, multimodal prehabilitation on perioperative functional and patient-reported outcomes (PROs) in patients undergoing surgical resection for non-small cell lung cancer (NSCLC).

Methods: This is a retrospective study with paired comparisons on consecutive patients worked up for surgical resection for suspected NSCLC referred for prehabilitation including exercise, nutritional, and PROs assessment in a single centre from October 2022 to August 2023. Patients participated in a hybrid programme, with twice-weekly, one-to-one sessions combing high-intensity interval-style and strength training with accompanying app-based exercise and lifestyle support. Functional outcomes were assessed via the 6-minute walk test (6MWT) and 1-minute sit-to-stand (1M-STS), and PROs were evaluated using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) and Patient-Generated Subjective Global Assessment (PG-SGA). A multivariable logistic regression analysis identified factors linked to significant PRO improvement.

Results: During the study period, 85 patients were referred, with 98% consenting and 91% (75/85) completing a median of five sessions over 2.5 weeks, with 69% ultimately undergoing surgical resection. There was significant improvement in 6MWT distance (62.8 m, P < 0.001), 1M-STS (8.9 repetitions < 0.001), EQ-5D-5L (+6 points, P = 0.012) and PG-SGA nutritional status (-0.64 points, P = 0.044). Female sex, lower deprivation index (most deprived) and fewer sessions were associated with greater PRO improvements.

Conclusions: Short-term hybrid prehabilitation for resectable NSCLC improves patient functional and subjective outcomes, particularly among females and those from more deprived areas. This approach appears to enhance preoperative fitness and PROs for patients undergoing surgery potentially reducing postoperative complications and improving postoperative quality of life.

Keywords: NSCLC resection; fitness for surgery; lung cancer surgery; patient-reported outcomes (PROs); prehabilitation; quality of life.

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Conflict of interest statement

No known conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome. Individual COI not related to the paper are disclosed separately. C.P. reports speakers’ honoraria from AstraZeneca, Medela, Johnson & Johnson, Roche; holds position as a BTOG Steering Committee Member. W.R. reports honoraria from AstraZeneca. A.J. has received grants from Gilead, Roche; received honoraria from AstraZeneca, Johnson & Johnson, MSD, Janssen, Pfizer, Bayer and Roche; participated on a data safety monitoring board or advisory board for BMS, AstraZeneca, Pfizer and MSD; and has held a position as a BTOG Steering Committee Member.

Figures

None
Graphical abstract
Figure 1:
Figure 1:
CONSORT flow diagram
See this image and copyright information in PMC

References

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