Identifying the Need for Prehabilitation in Cancer Patients Undergoing Nephrectomy or Nephroureterectomy
Bente Thoft Jensen1,2, Peter Blak Hjort1,3, Kathrine Melchiorsen1
1Department of Urology, Aarhus University Hospital, 8200 Aarhus, Denmark.
Cancers
|September 13, 2025
Summary
Prehabilitation may be needed for kidney cancer patients. Many patients show nutritional risks, anemia, and functional decline before and after surgery, indicating a need for early intervention.
Area of Science:
- Urology
- Oncology
- Geriatrics
Background:
- Prehabilitation benefits for renal cell carcinoma (RCC) and upper-tract urothelial carcinoma (UTUC) surgery patients are unknown.
- Evaluating physical function and baseline characteristics is crucial for identifying prehabilitation needs.
Purpose of the Study:
- To assess physical function and baseline characteristics in patients undergoing nephrectomy for RCC or nephroureterectomy for UTUC.
- To identify potential needs for prehabilitation in this patient cohort.
Main Methods:
- Prospective observational study of 62 patients (31 RCC, 31 UTUC).
- Baseline assessments included nutritional screening, frailty, hemoglobin/iron levels, smoking status, Six-Minute Walk Test (6MWT), and 30-Second Sit-to-Stand Test (30STS).
- Functional tests were repeated at discharge and two-week follow-up.
Main Results:
- High prevalence of nutritional risk (45% RCC, 68% UTUC), frailty (20%), and anemia (53%) at baseline.
- Significant functional impairment observed preoperatively (16-36% by 6MWT, 58% RCC/42% UTUC by 30STS).
- Postoperative functional decline peaked at discharge (59% RCC/82% UTUC below LLVs), with only partial recovery at follow-up.
Conclusions:
- Preoperative nutritional deficits, anemia, and functional impairment are common in patients undergoing kidney cancer surgery.
- Marked postoperative functional decline supports the need for early, individualized prehabilitation.
- Prehabilitation may improve recovery outcomes for patients undergoing nephrectomy or nephroureterectomy.
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