Multimodal prehabilitation management within the framework of enhanced recovery after surgery in patients undergoing lung cancer surgery: a scoping review

Within the Enhanced Recovery After Surgery (ERAS) framework, multimodal prehabilitation has emerged as a pivotal strategy to enhance outcomes for patients undergoing lung cancer surgery. Despite its growing recognition, there is a lack of a comprehensive synthesis of the key components and delivery models of multimodal prehabilitation. This scoping review aims to systematically explore the current landscape of multimodal prehabilitation for lung cancer surgery patients, offering a thorough evidence-based framework to guide its optimal clinical implementation and inform future research directions. Following a standard scoping review methodology, we conducted a comprehensive search of major English and Chinese databases (including PubMed, EBSCO, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and CBM) from their inception to June 30, 2025. Two researchers independently extracted and synthesized data from the included studies. The review identified 35 studies, including 22 randomized controlled trials. Multimodal protocols varied in composition, ranging from dual-modal (n = 18) to quadruple-modal (n = 5) approaches. Core components consistently included exercise therapy and pulmonary rehabilitation (n = 34 each), frequently supplemented by psychosocial (n = 20) and nutritional (n = 18) support. Multimodal prehabilitation is validated as a critical component of the ERAS pathway in lung cancer surgery, effectively enhancing functional recovery. However, the implementation is challenged by the time-sensitive nature of cancer treatment. Therefore, future care models must pivot toward personalized, home-based digital interventions that can ensure adherence and efficacy within the constrained preoperative window. Moving forward, standardizing these “short-course” protocols will be essential to optimizing both surgical safety and long-term quality of life.