Ovarian cancer and multimodal prehabilitation options - a case study

The aim of this case report is to present the impact of multimodal prehabilitation on the quality of life, cognitive performance, physical fitness, and nutritional status in a patient with advanced ovarian cancer.

A 74-year-old woman with high grade serous ovarian carcinoma pT3bN1a was scheduled for radical surgery following three cycles of neoadjuvant chemotherapy. She underwent a three-week intensive multimodal prehabilitation program in a 4/7 regimen involving physiotherapy, occupational therapy, nutritional counselling, psychological support, and supervision by a rehabilitation physician. The effect was evaluated using functional and cognitive tests, stress and disability scales, and body composition analysis (InBody).

Improvement was observed across all major domains: reduction in disability (WHODAS 20 → 5%), enhancement of cognitive function (MoCA 22 → 25), decreased perceived stress (PSS-10 17 → 11), reduction in frailty (FI 3 1), and restoration of full independence in activities of daily living (Katz Index 6/6). Physical performance showed marked gains (6MWT +42 m, 5×SST -6.5 s, handgrip strength +4 kg), while pulmonary function tests confirmed improved ventilatory capacity (FVC, FEV1, PEF). Nutritional assessment indicated a reduced risk of malnutrition according to the MUST screening tool, although bioimpedance analysis demonstrated a mild increase in total body fat and visceral adipose tissue.

Intensive multimodal prehabilitation positively influenced the patient's psychosensory-motor potential, reduced disability, enhanced perioperative fitness, and confirmed its indispensable role in oncogynecology.