Addition of the nutrition factor enhances the cancer prehabilitation program design for colorectal cancer patients: a multi-center cohort study

[Purpose] The purpose of this study was to investigate the interrelationship between different baseline functional capacity items, and their relationship with postoperative course in colorectal cancer patients. [Participants and Methods] This was a three-institution cohort study that included 127 patients scheduled for elective colorectal cancer surgery. Baseline functional capacity was evaluated using skeletal muscle index (SMI), six-minute walk test (6MWT), serum-albumin (Alb), vitality, and mental health before surgery. Postoperative findings, including C-reactive protein (CRP) levels 3 days post-operation, frequency of postoperative complications, and length of hospital stay (LOS), were evaluated based on the medical records. [Results] CRP was positively related to SMI, but negatively related to Alb level. LOS was negatively related to vitality. The 6MWT results and mental health-related findings were not significantly related to the postoperative course, but were directly and indirectly related to vitality, respectively. Alb level was also indirectly related to vitality through the 6MWT and mental health-related findings. The final constructed model demonstrated an acceptable fit to the data (goodness-of-fit index=0.958, adjusted goodness-of-fit index=0.930, comparative fit index=1.000, root mean square error of approximation=0.000). [Conclusion] Nutrition status, as measured by Alb level before surgery, may positively affect both the postoperative course and other functional capacity parameters.