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Prehabililtation in Retroperitoneal Sarcomas
Eyal Mor1,2, Hayden Snow1,2, Jenelle Loeliger2,3
1Division of Cancer Surgery, The Peter MacCallum Cancer Center, Melbourne, Victoria, Australia.
Background:
Retroperitoneal sarcoma (RPS) requires complex surgery with high post-operative morbidity. Prehabilitation aims to optimize the physical, psychological, and nutritional status of high-risk patients before surgery. This study outlines our experience with a multimodal prehabilitation program for RPS patients.
Methods:
We retrospectively analyzed 41 patients who underwent RPS resection and participated in prehabilitation (2020-2023) at a tertiary center, describing assessment findings and peri-operative outcomes.
Results:
A total of 41 patients were included in the analysis out of 132 patients who had surgery for RPS during the specified time period. All participated in a multimodal prehabilitation program, including physical, nutritional, and psychological support. The average program duration was 57 days (range, 42-132). Among 36 (88%) who completed cardiopulmonary exercise testing, the mean respiratory exchange ratio was 1.15 (±0.2), and peak vO2 was 14.9 (±4.1) mls/kg/min. Mean Australia-modified Karnofsky Performance Status (AKPS) was 85 (±10). Seventeen (41%) had an MST score ≥2, indicating malnutrition risk. Mean operative time was 5.7 (±2.4) hours; hospital and ICU stays averaged 12.5 (±8.1) and 1.3 (±1.6) days. Major post-operative complications (Clavien-Dindo ≥ 3) occurred in 9 patients (21%), with 2 (4%) requiring re-operation.
Conclusions:
A Multimodal prehabililtation program in retroperitoneal sarcoma is feasible and may be worthwhile for patients at high-risk of perioperative complications.
