Fit4Surgery for cancer patients during covid-19 lockdown – A systematic review and meta-analysis

T. van Gestel*, L. C. B. Groen, J. R. Puik, S. J. van Rooijen, H. J. van der Zaag-Loonen, L. J. Schoonmade, G. Danjoux, F. Daams, W. H. Schreurs, E. R. J. Bruns

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


Background: Prehabilitation is a promising method to enhance postoperative recovery, especially in patients suffering from cancer. Particularly during times of social distancing, providing home-based programmes may have become a suitable solution to increase compliance and effectiveness. Methods: In line with the PRISMA guidelines, a systematic review was conducted including trials that investigated the effect of home-based prehabilitation (HBP) in patients undergoing surgery for cancer. The primary outcome was postoperative functional capacity (6 min walk test, 6MWT). Secondary outcomes were postoperative complications and compliance. Results: Five randomized controlled trials were included with 351 patients undergoing surgery for colorectal cancer, oesophagogastric cancer, bladder cancer and non-small cell lung cancer. Three studies presented results of significant progress after eight weeks. The meta-analysis showed a significant improvement of the 6MWT in the prehabilitation group compared to the control group preoperatively (MD 35.06; 95% CI 11.58 to 58.54; p = .003) and eight weeks postoperatively (MD 44.91; 95% CI 6.04 to 83.79; p = .02) compared to baseline. Compliance rate varied from 63% to 83% with no significant difference between prehabilitation and control groups. These data must be interpreted with caution because of a high amount of heterogeneity and small sample sizes. Discussion: In conclusion, HBP may enhance overall functional capacity of patients receiving oncological surgery compared to standard of care. This could be a promising alternative to hospital-based prehabilitation regarding the current pandemic and further digitalization in the future. In order to increase accessibility and effectiveness of prehabilitation, home-based solutions should be further investigated.
Original languageEnglish
Pages (from-to)1189-1197
Number of pages9
JournalEuropean Journal of Surgical Oncology
Issue number6
Early online date2022
Publication statusPublished - Jun 2022

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