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2022-RA-1094-ESGO Implementation of a tri-modal prehabilitation intervention – KORE-INNOVATION: the first prospective clinical trial to assess a perioperative pathway to reduce postoperative complications in ovarian cancer patients
  1. Melisa Guelhan Inci-Turan1,
  2. Marlene Lee1,
  3. Magdalena Rattunde1,
  4. Stephanie Schneider2,
  5. Eva Schnura2,
  6. Julia Klews1,
  7. Manuela Bergjan3,
  8. Engi Algharably4,
  9. Adak Pirmorady Sehouli5,
  10. Anett Reißhauer6,
  11. Barbora Knappe-Drzikova1,
  12. Lena Zwanzleitner7,
  13. Stephanie Roll8,
  14. Thomas Reinhold8,
  15. Philipp Harter2 and
  16. Jalid Sehouli1
  1. 1Department of Gynecology with Center for Oncological Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany
  2. 2Department of Gynecology and Gynecological Oncology, Evangelische Kliniken Essen Mitte, Essen, Germany
  3. 3Department of Nursing Directorate, Charité Universitätsmedizin Berlin, Berlin, Germany
  4. 4Institute for Clinical Pharmacology and Toxicology, Charité Universitätsmedizin Berlin, Berlin, Germany
  5. 5Department of Psychosomatic Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
  6. 6Department of Physical Medicine and Rehabilitation, Charité Universitätsmedizin Berlin, Berlin, Germany
  7. 7Techniker Krankenkasse, Hamburg, Germany
  8. 8Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany


Introduction/Background The effectiveness of prehabilitation in improving physical capacity for patients undergoing surgery has been shown for patients in orthopedic, abdominal, or cardiological surgeries. Ovarian cancer patients have an exceptionally high risk for severe postoperative complications due to the extent of the surgical treatment, often including multi-visceral resection. We report our first experiences of implementing a tri-modal prehabilitation intervention as part of the KORE-INNOVATION trial.

Abstract 2022-RA-1094-ESGO Figure 1

Methodology KORE-INNOVATION is an ongoing clinical trial to implement and assess an innovative perioperative care pathway to reduce complications (primary endpoint) for patients undergoing surgery for ovarian cancer through the implementation of a prehabilitation strategy combined with the ‘enhanced recovery after surgery’ (ERAS)-pathway. The prehabilitation intervention consists of three modules: a personalized empowerment intervention, a personalized physical exercise-program-, and a personalized metabolic screening and nutrition intervention. Before prehabilitation, a complex baseline assessment, consisting of the Fried frailty assessment, metabolic and physical assessments, and detailed patient history, is performed to develop a personalized prehabilitation plan targeting individual deficits (figure 1).

Results Prehabilitation ranged from one to three weeks and was overseen by a multi professional and interdisciplinary KORE team of physicians, nurses, physiotherapists, and nutritionists. The majority of patients conducted prehabilitation as outpatients. Weekly phone calls were made to monitor patients’ adherence and adjust treatment plans, if necessary. Patients reported feeling more capacitated and resilient after undergoing the prehabilitation program.

Conclusion A structured, individualized prehabilitation program delivered through a specialized multi professional team presents an opportunity to prepare patients holistically for the stressful experience of debulking surgery and might contribute to faster postoperative reconditioning. Prehabilitation is an important addition to the ERAS pathway and should be considered a relevant part of perioperative care.

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