One-Year Follow-Up after Multimodal Prehabilitation Interventions in Radical Cystectomy

Abstract

Multimodal prehabilitation is the process of enhancing physiological, nutritional, and psychological resilience to increase patients’ functional capacity before major cancer surgery and aims to empower the patient to withstand the pending stress of major surgery and ultimately to improve long-term outcomes. The effect of physical prehabilitation to counteract the physical decline in surgical cancer patients has been documented; however, long-term results have not yet been published. This follow-up study aims to evaluate 1-year results on the efficacy of physical prehabilitation after bladder cancer surgery. The efficacy of prehabilitation was measured over the course of 1 year in 107 patients randomized to (1) pre- and rehabilitation or (2) standard care divided by n = 50 in the intervention (I) and n = 57 in the standard group (S). Physical function was measured by muscle leg power, and nutritional status was expressed with handgrip strength. Prehabilitation in major bladder cancer surgery can significantly improve physical function with 19.8 Watt/kg (p = 0.04), lean body mass (p = 0.047) and body cell mass (p = 0.03), and regained nutritional status one year after surgery. The results demonstrate that the restoration of physical function is vital to a full recovery.

Nutritional Prehabilitation in Patients Undergoing Cystectomy: A Systematic Review

“…This process includes nutritional, physical, and psychological assessments to establish a baseline functional level and pinpoint impairments. Targeted interventions are then employed to bolster the patient’s health, aiming to reduce the incidence and severity of present and future impairments [ 4 ]. This prepares the patient to better withstand the imminent physical challenges arising from surgical tissue trauma, reduced physical activity, and anxiety, which collectively contribute to a swift decline in functional capacity [ 5 ].…”