Prehabilitation for colon cancer surgery: a systematic review of quality-of-life outcomes and a feasibility study

Abstract Purpose To evaluate the feasibility of short-term prehabilitation and its impact on quality of life in patients with colorectal cancer through a systematic review and a feasibility study. Methods The systematic review was conducted in accordance with the PRISMA guidelines. PubMed, PubPsych, CINAHL, EMBASE, Web of Science and EBSCOhost were searched for studies evaluating quality of life in colorectal cancer patients undergoing prehabilitation. We conducted a prospective non-randomised interventional feasibility study, with a 2-week post-surgery follow-up, enrolling patients diagnosed with colon cancer. Results The systematic review included six studies from 517 unique records for final analysis. Among six studies, evidence for quality-of-life benefits of prehabilitation was conflicting but predominantly favourable, with generally low-to-moderate study quality and substantial heterogeneity. In the feasibility study, 110 patients were eligible for inclusion; 70 (64%) were included, and 63 completed the entire study. Of the 32 patients in the intervention group, compliance > 80% was observed in 66% (nutrition) and 88% (physical activity) of patients, with a median compliance of 100% for both. Quality-of-life outcomes were explored as secondary measures and showed potential favourable trends following prehabilitation. Conclusion Evidence on the effect of prehabilitation on quality of life in colorectal cancer remains inconsistent; our feasibility study shows that short-term multimodal prehabilitation is feasible and supports the need for adequately powered trials.