Rationales for Prehabilitation Programs in Patients Preparing for Oncologic Surgery: A Systematic Review

Area of Science:

• Oncology
• Rehabilitation Medicine
• Evidence-Based Practice

Background:

• Prehabilitation aims to enhance patient resilience and recovery following surgery.
• Understanding the rationale behind prehabilitation content can optimize program design.
• This systematic review examines rationales, interventions, and outcomes in oncological prehabilitation studies.

Purpose of the Study:

• To systematically review the rationales, intervention components, and outcomes of prehabilitation studies in oncological populations.
• To identify opportunities for optimizing prehabilitation programs based on current practices and reported rationales.

Main Methods:

• Systematic search of MEDLINE, Embase, and Scopus databases.
• Inclusion of comparative prehabilitation studies in oncological surgery patients.
• Extraction of reported rationales, program content (exercise type, frequency, intensity, duration), and primary endpoints.

Main Results:

• 140 studies (24,925 patients) were included.
• Improving physical fitness (cardiorespiratory) was the most common rationale (89%).
• Psychological (33%) and metabolic (20%) rationales were less frequent. Exercise was predominantly supervised (41%), often 3x/week, including anaerobic components. Program duration varied (1-12 weeks). Surgical outcomes were the most reported endpoints (42%).

Conclusions:

• Physical fitness is a primary rationale, but specific component rationales are often implicit.
• Prehabilitation content and duration vary widely, influenced by feasibility and time constraints.
• Standardized outcomes and mechanistically grounded approaches are recommended to improve prehabilitation design and effectiveness.