Implementing a Multimodal Prehabilitation Program to Radical Cystectomy in a Comprehensive Cancer Center: A Pilot...

Area of Science:

• Oncology
• Surgical Oncology
• Rehabilitation Medicine

Background:

• Radical cystectomy (RC) is associated with significant postoperative morbidity.
• Prehabilitation, a preoperative conditioning strategy, shows promise in improving surgical outcomes.
• Its effectiveness in bladder cancer patients undergoing RC requires further investigation.

Purpose of the Study:

• To assess the feasibility and effectiveness of a multimodal prehabilitation program in bladder cancer patients scheduled for RC.
• To evaluate patient adherence to the prehabilitation regimen.
• To measure changes in physical condition and functional capacity post-surgery.

Main Methods:

• A pilot study involving 32 bladder cancer patients undergoing RC.
• A 2-week prehabilitation program including physical exercises and nutritional support.
• Assessment of adherence, handgrip strength, bio-impedance, and the six-minute walk test (6MWT) at baseline, day of surgery, and 6 weeks post-surgery.

Main Results:

• Adherence rates were 62% for exercises and 81% for nutrition.
• The six-minute walk test showed a significant improvement of 9.2% from baseline to 6-week follow-up (p=0.03).
• Handgrip strength improved by 6.8% from baseline and was maintained post-surgery (p=0.001).

Conclusions:

• Multimodal prehabilitation is feasible and can be implemented in clinical practice for patients undergoing radical cystectomy.
• The program effectively maintained or improved physical functioning post-surgery compared to baseline.
• Prehabilitation offers a promising strategy to mitigate postoperative complications and enhance recovery in bladder cancer patients.