All Wales Ovarian Cancer Prehabilitation Project (AWOCPP).
Josh Courtney McMullan1, Catherine Smith2, Rosalind Jones3
1Gynaecological Oncology, University Hospital of Wales, Cardiff, Cardiff, UK joshcmcmullan@doctors.org.uk.
BMJ Open Quality
|February 25, 2025
Summary
Personalised prehabilitation significantly improved outcomes for advanced ovarian cancer patients in Wales. This intervention reduced hospital stays and postoperative complications, enhancing the overall treatment pathway.
Area of Science:
- Oncology
- Surgical Oncology
- Public Health
Background:
- Advanced ovarian cancer (stage 3+) diagnosis is common in Wales, often requiring chemotherapy and cytoreductive surgery.
- Postoperative morbidity frequently leads to extended hospital stays and delayed chemotherapy initiation.
- Personalised prehabilitation addresses modifiable risk factors to improve perioperative outcomes.
Purpose of the Study:
- To implement and evaluate a multimodal, personalised prehabilitation program for advanced ovarian cancer patients undergoing surgery in Wales.
- To assess the impact of prehabilitation on length of stay (LOS), postoperative complications, and surgery-to-chemotherapy interval (SCI).
- To gather data for future health economic evaluation and potential national rollout.
Main Methods:
- Quality improvement methods were employed to implement the prehabilitation program.
- A personalized approach identified individual modifiable risk factors (exercise, smoking cessation, medical/nutritional optimization, emotional support).
- Outcome measures (LOS, complications, SCI) were compared to a historical dataset (2018-2019) prior to prehabilitation availability.
Main Results:
- Median LOS decreased from 6 to 5 days (p=0.29).
- Postoperative complications reduced: Grade 2 (16.9% to 12.7%), Grade 3 (4.4% to 1.8%), Grade 4+5 (0.6% to 0%).
- Median SCI was 43.5 days post-prehabilitation versus 40 days historically (p=0.65).
Conclusions:
- Prehabilitation positively impacted the treatment pathway for advanced ovarian cancer in Wales.
- Further development is needed to enhance patient engagement and establish cost-effective delivery for standard care.
- Personalised prehabilitation shows promise in improving perioperative outcomes and streamlining cancer treatment.
Related Concept Videos
02:59Cancer Prevention
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
02:56Treatment Resistant Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
02:59Cancer Prevention
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
02:56Treatment Resistent Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
01:27Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...