Multidisciplinary Prehabilitation Reduces Hospitalization Time and Suggests Improved Survival in Patients with Radiologically Diagnosed Lung Cancer

Background/Objectives: Lung cancer is the commonest cause of cancer death worldwide. Treatment efficacy is improving, but treatment rates remain low. We aimed to assess the impact of tri-modality early prehabilitation (single in-person interventions by a senior doctor in palliative/supportive care, physiotherapist and dietitian) on patients with a radiological diagnosis of lung cancer. Methods: Patients were approached as soon as they were told they had a radiological diagnosis of lung cancer. Prehabilitation took place in parallel with a patient’s investigative pathway for lung cancer. Routine data for admissions and survival was assessed retrospectively for prehabilitation patients and compared to an appropriate group of historical controls. Results: A total of 97 patients with stage 3 or 4 lung cancer underwent prehabilitation and were compared to 199 historical controls. There were no obvious statistical differences in gender or age between the cohorts. There was a trend towards reduced mean length of stay (LOS) from 7.6 days to 2.6 days in the patients who underwent all three interventions and from 7.6 days to 3 days in all comers (p = 0.053), with a significantly shorter admission in those who were admitted (p = 0.0014). There was a reduction in time spent in hospital from 486 days to 172 days per 100 patients receiving prehabilitation (a saving of 3.1 days per patient participating). Survival appeared to improve 6 months after diagnosis, at 61% in the prehabilitation cohort (95% CI: 51.8–72.0%, p = 0.029) vs. 47.7% in the historical controls (95% CI: 41.3–55.2%, p = 0.029). Life-prolonging treatment rates in stage 4 disease increased from 26% to 42% and all-comer best supportive care rates reduced from 45% to 28%. Conclusions: Early prehabilitation appears to reduce time spent in hospital. It may also improve treatment rates and short-term survival in patients being investigated for lung cancer.