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Changes in Functional Capacity and Body Composition After a Multimodal Prehabilitation Program in Patients with
Luuk D Drager1, Baukje van den Heuvel2, Dieuwke Strijker2
1Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. Luuk.drager@radboudumc.nl.
Annals of Surgical Oncology
|February 23, 2026
Summary
Prehabilitation significantly improved functional capacity and body composition in cancer patients undergoing abdominal surgery. However, these gains were not sustained long-term postoperatively, highlighting the need for continued support.
Area of Science:
- Oncology
- Exercise Physiology
- Surgical Outcomes
Background:
- Preoperative functional capacity and body composition impact surgical outcomes in cancer patients.
- Long-term effects and exercise dose-response of prehabilitation remain unclear.
Purpose of the Study:
- To investigate changes in functional capacity and body composition during and after prehabilitation.
- To evaluate exercise dose-response associations in patients undergoing abdominal cancer surgery.
Main Methods:
- 816 patients from the F4S PREHAB trial (March 2021-April 2024) undergoing elective abdominal surgery for cancer were included.
- Functional capacity (peak oxygen uptake, exercise capacity, muscle strength) and body composition were assessed at baseline, post-prehabilitation, and 3 months postoperatively.
- Linear mixed models were used to analyze changes over time and dose-response associations.
Main Results:
- Significant improvements were observed in peak oxygen uptake, exercise capacity, muscle strength, body weight, and fat-free mass post-prehabilitation.
- Functional capacity measures returned to or declined below baseline values postoperatively.
- Exercise dose-response associations were found, varying by tumor type, neoadjuvant therapy, malnutrition risk, and compliance.
Conclusions:
- Prehabilitation enhances functional capacity and body composition in abdominal cancer surgery patients.
- These improvements are generally not sustained postoperatively.
- Future research should explore targeted approaches and integration with postoperative rehabilitation strategies.
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