Prehabilitation in Frail Patients Undergoing Cancer Surgery: A Systematic Review and Meta-analysis.

Area of Science:

• Oncology
• Geriatrics
• Surgical Outcomes

Background:

• Limited evidence exists on prehabilitation for frail cancer patients.
• Prehabilitation aims to improve patient outcomes before surgery.

Purpose of the Study:

• To systematically review and meta-analyze the effectiveness of prehabilitation in frail cancer patients.
• Key outcomes assessed were postoperative complications and hospital length of stay (LOS).

Main Methods:

• Comprehensive database search (MEDLINE, Embase, Cochrane, etc.) up to December 2023.
• Included five randomized controlled trials (RCTs) with 466 patients.
• Random-effects meta-analysis used to calculate relative risk (RR) and mean difference (MD) with 95% confidence intervals (CI).

Main Results:

• Prehabilitation reduced any postoperative complications (RR = 0.82; 95% CI = 0.71-0.95).
• No significant effect was found for major postoperative complications (RR = 0.89; 95% CI = 0.71-1.11).
• Hospital length of stay (LOS) was not significantly affected (MD = 0.3; 95% CI = -0.68 to 1.28).

Conclusions:

• Prehabilitation significantly decreases the overall rate of postoperative complications in frail cancer patients.
• The effectiveness of prehabilitation for major postoperative outcomes remains unclear due to insufficient evidence.