Lindel C Dewberry1, Lisa J Wingrove2, Megan D Marsh2, Ashley E Glode2, Tracey E Schefter3, Stephen Leong4, William T Purcell4, Martin D McCarter5. 1. Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado. Electronic address: lindel.dewberry@ucdenver.edu. 2. Department of Surgery, University of Colorado Cancer Center, Aurora, Colorado. 3. Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado. 4. Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. 5. Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
Abstract
BACKGROUND: Locally advanced esophageal cancer is often treated with neoadjuvant therapy followed by surgery. Many patients present with or experience clinical deconditioning during neoadjuvant therapy. Prehabilitation programs in other areas of surgery have demonstrated improved postoperative outcomes. The aims of this study were to evaluate the feasibility of a pilot prehabilitation program and determine preliminary effects on surgical and cancer-related outcomes. METHODS: A retrospective review of patients treated at a single institution with resectable esophageal cancer was performed (n = 22). Patients in the prehabilitation group received protocol-structured intervention in several clinical domains including nutrition, psychosocial support, and physical exercise. RESULTS: Clinical stage and comorbidities were well matched between groups. The structured prehabilitation program was feasible and well received by participants. Fewer patients required admission during neoadjuvant therapy in the prehabilitation group (27.3% versus 54.5%). Percentage weight loss during treatment was 3.0% in the prehabilitation group versus 4.3% in the control group. Compared with the control group, the prehabilitation group demonstrated 0.0% versus 18.2% 30-d postoperative readmission rate and 18.2% versus 27.3% 90-d postoperative readmission rate. There were no statistically significant differences between groups in regard to complications or mortality. CONCLUSIONS: The pilot prehabilitation program demonstrated feasibility of implementing a structured program for patients receiving neoadjuvant therapy for esophageal cancer. Although the small population limits evaluation of statistical significance, trends in the data suggest a potential benefit of the prehabilitation program on neoadjuvant hospital admission rates, postsurgical readmission rates, and nutritional status.
BACKGROUND: Locally advanced esophageal cancer is often treated with neoadjuvant therapy followed by surgery. Many patients present with or experience clinical deconditioning during neoadjuvant therapy. Prehabilitation programs in other areas of surgery have demonstrated improved postoperative outcomes. The aims of this study were to evaluate the feasibility of a pilot prehabilitation program and determine preliminary effects on surgical and cancer-related outcomes. METHODS: A retrospective review of patients treated at a single institution with resectable esophageal cancer was performed (n = 22). Patients in the prehabilitation group received protocol-structured intervention in several clinical domains including nutrition, psychosocial support, and physical exercise. RESULTS: Clinical stage and comorbidities were well matched between groups. The structured prehabilitation program was feasible and well received by participants. Fewer patients required admission during neoadjuvant therapy in the prehabilitation group (27.3% versus 54.5%). Percentage weight loss during treatment was 3.0% in the prehabilitation group versus 4.3% in the control group. Compared with the control group, the prehabilitation group demonstrated 0.0% versus 18.2% 30-d postoperative readmission rate and 18.2% versus 27.3% 90-d postoperative readmission rate. There were no statistically significant differences between groups in regard to complications or mortality. CONCLUSIONS: The pilot prehabilitation program demonstrated feasibility of implementing a structured program for patients receiving neoadjuvant therapy for esophageal cancer. Although the small population limits evaluation of statistical significance, trends in the data suggest a potential benefit of the prehabilitation program on neoadjuvant hospital admission rates, postsurgical readmission rates, and nutritional status.
Authors: Timo Niels; Christoph T Baltin; Guido Kosanke; Ulrich K Fetzner; Arnulf H Hoelscher; Elfriede Bollschweiler; Jan-Hendrik Naendrup; Freerk T Baumann Journal: In Vivo Date: 2022 Jul-Aug Impact factor: 2.406
Authors: Daniel Santa Mina; Stefanus J van Rooijen; Enrico M Minnella; Shabbir M H Alibhai; Priya Brahmbhatt; Susanne O Dalton; Chelsia Gillis; Michael P W Grocott; Doris Howell; Ian M Randall; Catherine M Sabiston; Julie K Silver; Gerrit Slooter; Malcolm West; Sandy Jack; Franco Carli Journal: Front Oncol Date: 2021-01-11 Impact factor: 6.244