The effect of a pre- and post-operative exercise programme versus standard care on physical fitness of patients with oesophageal and gastric cancer undergoing neoadjuvant treatment prior to surgery (The PERIOP-OG Trial): Study protocol for a randomised controlled trial

Abstract

Background: Advances in peri-operative oncological treatment, surgery and peri-operative care have improved survival for patients with oesophagogastric cancers. Neoadjuvant cancer treatment (NCT) reduces physical fitness, which may reduce both compliance and tolerance of NCT as well as compromising post-operative outcomes. This is particularly detrimental in a patient group where malnutrition is common and surgery is demanding. The aim of this trial is to assess the effect on physical fitness and clinical outcomes of a comprehensive exercise training programme in patients undergoing NCT and surgical resection for oesophagogastric malignancies.

Current Landscape of Nutrition Within Prehabilitation Oncology Research: A Scoping Review

“…Only 37 of the 110 studies of prehabilitation had a nutrition treatment component. The study designs were as follows: 27% ( n = 10) were protocols ( 18 – 27 ), 14% ( n = 5) were pilot studies ( 8 , 28 – 31 ), 5% ( n = 2) were descriptions of prehabilitation programs ( 32 , 33 ), 3% ( n = 1) were case reports ( 34 ), 3% ( n = 1) were feasibility studies ( 35 ), and 3% were qualitative studies ( 36 ). Of these 37 studies, 30% ( n = 11) were cohort studies ( 37 – 47 ) and 16% ( n = 6) were RCTs ( 48 – 53 ).…”

“…The most commonly used tools to screen or assess for malnutrition were Subjective Global Assessment/Patient-Generated-Subjective Global Assessment ( 8 , 27 , 31 , 35 , 51 ), Nutrition Risk Screening-2002 ( 8 , 19 , 51 , 52 ), Mini Nutritional Assessment ( 23 , 28 , 40 , 41 ), Simplified Nutritional Appetite Questionnaire ( 23 , 37 , 41 ), and Malnutrition Universal Screening Tool ( 22 , 46 ). The most common nutritional parameters were pre-albumin or albumin ( 18 , 19 , 23 , 34 , 38 , 41 , 46 ), which were reported by 19% ( n = 7) of studies as a nutritional parameter [although, it is not considered to robustly reflect nutritional status in patients with cancer ( 54 )], and 27% ( n = 10) reported use of food records or recalls ( 8 , 18 , 27 , 34 , 35 , 48 – 51 , 53 ). Forty-three percent ( n = 16) of studies included nutritional indicators, such as weight, body mass index (BMI), or body composition as an element of the assessment ( 18 , 19 , 23 , 27 – 30 , 33 , 35 , 38 , 40 , 41 , 44 , 46 , 50 , 53 ).…”

“…The most common nutritional parameters were pre-albumin or albumin ( 18 , 19 , 23 , 34 , 38 , 41 , 46 ), which were reported by 19% ( n = 7) of studies as a nutritional parameter [although, it is not considered to robustly reflect nutritional status in patients with cancer ( 54 )], and 27% ( n = 10) reported use of food records or recalls ( 8 , 18 , 27 , 34 , 35 , 48 – 51 , 53 ). Forty-three percent ( n = 16) of studies included nutritional indicators, such as weight, body mass index (BMI), or body composition as an element of the assessment ( 18 , 19 , 23 , 27 – 30 , 33 , 35 , 38 , 40 , 41 , 44 , 46 , 50 , 53 ). Body composition analysis included computed tomography (CT) ( 18 ), bioimpedance ( 19 ), and skinfold assessments ( 24 , 27 , 35 ).…”

“…Forty-three percent ( n = 16) of studies included nutritional indicators, such as weight, body mass index (BMI), or body composition as an element of the assessment ( 18 , 19 , 23 , 27 – 30 , 33 , 35 , 38 , 40 , 41 , 44 , 46 , 50 , 53 ). Body composition analysis included computed tomography (CT) ( 18 ), bioimpedance ( 19 ), and skinfold assessments ( 24 , 27 , 35 ).…”

Preoperative nutritional risk index and postoperative one-year skeletal muscle loss can predict the prognosis of patients with gastric cancer: a registry based study

“…Among several prognostic factors which were signi cant in this study, the dSMI and preoperative NRI could be valuable indicators because they have potentials to improve prognosis through efforts to enhance the nutritional status before surgery or maintain the muscle mass with intensive exercise and nutritional support after gastrectomy. Recently, exercise and physical activities during cancer treatment has been greatly emphasized in various malignancies, and the therapeutic bene t of exercise interventions on cancer patients have been investigated [24][25][26][27] . In addition, in 2020, the American Cancer Society guidelines has been issued for diet and physical activity for cancer patients 28 .…”