Article Text
Abstract
Introduction/Background There is limited evidence regarding the improvement in functional capacity, nutritional status, and psychological well-being through prehabilitation programs prior to advanced ovarian cancer (AOC) surgery. This study aimed to evaluate the effects of a multimodal prehabilitation in AOC patients in terms of improving physical, nutritional and psychological wellbeing during the preoperative period.
Methodology This single-center, ambispective study included patients with advanced ovarian cancer eligible for primary or interval cytoreductive surgery. Participants attended a multimodal prehabilitation program comprising medical optimization, supervised exercise training, nutritional counselling and supplementation, as well as psychological support. Changes in functional capacity, nutritional status, and psychological wellbeing were collected at the beginning of the program and at program completion, prior to surgery.
Results 59 patients were included for cytorreductive surgery from July 2019 to May 2023 and 35 (59%) were assessed pre-surgery. Patients attended a median of 8 supervised exercise training sessions (IQR 6–12) during prehabilitation, with no differences being found between primary or interval cytoreductive surgery (P>0.05). No adverse events were reported. Median adherence reached 75% (IQR 58–87) for the whole sample. A significant improvement was observed in functional capacity according to the 6-Minute Walk Test (mean 33.1m, 95%CI: 10.9, 55.6) as well as the sit-to-stand test (+3.3 reps; 95% CI: 1.8, 4.8), with both being above the minimal clinically important difference (MCID) of 14 and 2 repetitions respectively. Additionally, patients also reported a significant decrease of 2.3, 2.1 and 4.4 points in the depression, anxiety and total scores of the Hospital Anxiety and Depression Scale.
Conclusion Multimodal prehabilitation in patients with AOC undergoing cytorreductive surgery improves pre-operative physical functioning as well as decrease emotional distress. Further controlled studies with a larger sample size are warranted to demonstrate that improvement in functional capacity, nutritional status, and psychological well-being through prehabilitation programs correlates with a reduction in postoperative complications.
Disclosures All authors declare no conflict of interest.