Current developments in prehabilitation in urologic oncology

Area of Science:

• Urologic Oncology
• Prehabilitation Science
• Perioperative Care

Background:

• Prehabilitation involves interventions before major procedures to enhance functional capacity.
• The goal is to improve therapy candidacy, tolerance to toxicity, and recovery.
• This review focuses on prehabilitation in Urologic Oncology.

Purpose of the Study:

• Detail key tenets of prehabilitation.
• Synthesize advances in prehabilitation science within Urologic Oncology.
• Discuss methodologic considerations for future investigations.

Main Methods:

• Review of contemporary prehabilitation clinical trials.
• Evaluation of unimodal (exercise, nutrition, cognition) and multimodal interventions.
• Focus on trials in patients undergoing surgery for genitourinary malignancies.

Main Results:

• Unimodal interventions show variable improvements in strength, balance, and quality of life.
• Preoperative exercise demonstrates some benefits.
• Presurgical immunonutrition has not yet shown significant benefits in uro-oncology.
• Multimodal prehabilitation shows potential for comprehensive benefits, including improved outcomes and reduced hospital stay.

Conclusions:

• Early prehabilitation studies in genitourinary cancer surgery yield mixed results.
• Interventions must be pragmatic, scalable, and feasible for patients with multimorbidity.
• Personalized prehabilitation integrated with enhanced recovery pathways promises improved patient resilience and outcomes.