Multimodal prehabilitation in patients with gastrointenstinal cancer and cachexia: results of pilot study

Background. Patients undergoing surgical treatment for gastrointestinal tumors often suffer from symptoms of cachexia and sarcopenia. Preoperative preparation, or “prehabilitation”, is a potentially effective new approach to managing these patients. Aim. To evaluate whether multimodal prehabilitation decreases postoperative complications and improves functional recovery in cachexic patients undergoing gastrointestinal cancer surgery, in comparison to usual clinical care. Materials and methods. This prospective cohort study included data on 36 patients who underwent surgical treatment for gastrointestinal cancer from 2022 to 2023 at our cancer hospital. Sarcopenia and cachexia were assessed preoperatively using modern international consensus criteria. Patients participated in remote comprehensive prehabilitation program which encompassed nutritional and psychological support and supervised exercise. After prehabilitation functional results were assessed. Also, the 30-day postoperative complication rate measured according to the Clavien–Dindo criteria as well as 30-day and 90-day mortality. Results. After prehabilitation, 24 (66.6%) patients showed a statistically significant decrease in 400 m walking time (p = 0.028); 25 (69.4%) patients gained weight from 0.5 to 6 kg (p 0.001). Conclusion. Multimodal remote prehabilitation can improve functional status in patients with gastrointestinal cancer and cachexia.