+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial



Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial



JAMA Surgery 153(12): 1081-1089



Preserving functional capacity is a key element in the care continuum for patients with esophagogastric cancer. Prehabilitation, a preoperative conditioning intervention aiming to optimize physical status, has not been tested in upper gastrointestinal surgery to date. To investigate whether prehabilitation is effective in improving functional status in patients undergoing esophagogastric cancer resection. A randomized clinical trial (available-case analysis based on completed assessments) was conducted at McGill University Health Centre (Montreal, Quebec, Canada) comparing prehabilitation with a control group. Intervention consisted of preoperative exercise and nutrition optimization. Participants were adults awaiting elective esophagogastric resection for cancer. The study dates were February 13, 2013, to February 10, 2017. The primary outcome was change in functional capacity, measured with absolute change in 6-minute walk distance (6MWD). Preoperative (end of the prehabilitation period) and postoperative (from 4 to 8 weeks after surgery) data were compared between groups. Sixty-eight patients were randomized, and 51 were included in the primary analysis. The control group were a mean (SD) age, 68.0 (11.6) years and 20 (80%) men. Patients in the prehabilitation group were a mean (SD) age, 67.3 (7.4) years and 18 (69%) men. Compared with the control group, the prehabilitation group had improved functional capacity both before surgery (mean [SD] 6MWD change, 36.9 [51.4] vs -22.8 [52.5] m; P < .001) and after surgery (mean [SD] 6MWD change, 15.4 [65.6] vs -81.8 [87.0] m; P < .001). Prehabilitation improves perioperative functional capacity in esophagogastric surgery. Keeping patients from physical and nutritional status decline could have a significant effect on the cancer care continuum. ClinicalTrials.gov Identifier: NCT01666158.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065764865

Download citation: RISBibTeXText

PMID: 30193337

DOI: 10.1001/jamasurg.2018.1645


Related references

Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation. Bmc Cancer 19(1): 98, 2019

Prehabilitation with Whey Protein Supplementation on Perioperative Functional Exercise Capacity in Patients Undergoing Colorectal Resection for Cancer: A Pilot Double-Blinded Randomized Placebo-Controlled Trial. Journal of the Academy of Nutrition and Dietetics 116(5): 802-812, 2016

Effect of epidural anesthesia and analgesia on postoperative functional exercise capacity and quality of life A randomized clinical trial. Regional Anesthesia and Pain Medicine 26(2 Suppl.): 9, March-April, 2001

Inflammatory biomarkers and effect of exercise on functional capacity in patients with heart failure: Insights from a randomized clinical trial. European Journal of Preventive Cardiology 24(8): 808-817, 2017

Randomized clinical trial of prehabilitation in colorectal surgery. British Journal of Surgery 97(8): 1187-1197, 2010

Protein timing has no effect on lean mass, strength and functional capacity gains induced by resistance exercise in postmenopausal women: A randomized clinical trial. Clinical Nutrition 2019:, 2019

Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial. Clinical Rehabilitation 24(2): 137-148, 2010

Considerations in Prehabilitation for Esophagogastric Cancer Surgery. JAMA Surgery 154(5): 463, 2019

Effect of High-Intensity Interval Versus Continuous Exercise Training on Functional Capacity and Quality of Life in Patients With Coronary Artery Disease: A RANDOMIZED CLINICAL TRIAL. Journal of Cardiopulmonary Rehabilitation and Prevention 36(2): 96-105, 2016

Multimodal prehabilitation improves functional capacity before and after colorectal surgery for cancer: a five-year research experience. Acta Oncologica 56(2): 295-300, 2017

Impact of exercise on the functional capacity and pain of patients with knee osteoarthritis: a randomized clinical trial. Revista Brasileira de Reumatologia 52(6): 876-882, 2012

Four-week prehabilitation program is sufficient to modify exercise behaviors and improve preoperative functional walking capacity in patients with colorectal cancer. Supportive Care in Cancer 25(1): 33-40, 2017

Epidural analgesia enhances functional exercise capacity and health-related quality of life after colonic surgery: results of a randomized trial. Anesthesiology 97(3): 540-549, 2002

Epidural Analgesia Enhances Functional Exercise Capacity and Health-Related Quality of Life After Colonic Surgery: Results of a Randomized Trial. Survey of Anesthesiology 47(4): 236-237, 2003

Sub-xyphoid pleural drain as a determinant of functional capacity and clinical results after off-pump coronary artery bypass surgery: a randomized clinical trial. Interactive Cardiovascular and Thoracic Surgery 19(3): 382-387, 2014