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Prehabilitation Practices for Patients Undergoing Cancer Surgery-An International Survey
Daniel Steffens1,2,3, Scott Venter1,2, Preet Makker1
1Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia.
World Journal of Surgery
|December 12, 2025
Summary
Prehabilitation programs for cancer surgery patients vary widely globally. Lack of funding and resources are the main barriers to widespread adoption, highlighting the need for international guidelines.
Area of Science:
- Oncology
- Surgical Oncology
- Geriatric Surgery
Background:
- Aging populations increase demand for surgical capacity.
- Modifiable risk factors like deconditioning and malnutrition worsen postoperative outcomes.
- Multimodal prehabilitation (exercise, nutrition, psychological support) shows promise for cancer surgery patients.
Purpose of the Study:
- To describe current prehabilitation practices in international cancer centers.
- To identify variations in prehabilitation implementation.
- To understand barriers to prehabilitation adoption.
Main Methods:
- Cross-sectional online survey conducted November 2023 - February 2024.
- International, multidisciplinary participants with prehabilitation expertise surveyed.
- Responses analyzed by World Bank region and income class.
Main Results:
- 1409 respondents from 663 hospitals participated.
- Prehabilitation is standard of care in 21.1% of hospitals; 29.9% offer it to select patients.
- Key barriers: lack of funding/resources (39.4%) and low institutional interest (10.6%).
- Most common interventions: nutrition (36.2%), physical exercise (29.7%), psychological support (23.8%).
Conclusions:
- Significant global variation exists in prehabilitation practices.
- Lack of institutional funding and resources hinders widespread prehabilitation.
- Future trials and international guidelines may improve global prehabilitation uptake.
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