The effect of a multimodal prehabilitation programme on preoperative physical fitness and nutritional status of women with gynaecological cancer

IF 4.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-10-21 DOI:10.1016/j.ygyno.2025.10.012

J. Dhanis , J.M.A. Pijnenborg , C.J.H.M. van Laarhoven , S. Verlaan , B. van der Heuvel , A. Smits

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引用次数: 0

Abstract

Background

Surgical treatment for gynaecological malignancies is still associated with high postoperative morbidity. Multimodal prehabilitation may improve functional capacity and thereby reduce surgical-related morbidity. Therefore, this study aims to assess the effect of multimodal prehabilitation on physical fitness and nutritional status of gynaecological oncology patients.

Methods

Within the F4S-PREHAB trial, a stepped-wedge trial assessing the effect of multimodal prehabilitation comprising exercise, nutrition, psychological support and intoxication cessation, a subgroup analysis was performed in women with gynaecological cancer undergoing surgery between May 2022 and April 2024 at the Radboudumc, Nijmegen. Physical fitness was compared before and after participation using estimated peak oxygen uptake, muscle strength (indirect 1-Repetition Maximum (1-RM) leg press), handgrip strength and Five-times Chair-Stand-Test. In addition, nutritional status was assessed through risk of malnutrition assessments. Further outcomes include the effect on body composition and biomarkers (Haemoglobin, Leukocytes, C-Reactive Protein, Albumin).

Results

In total, 140 women underwent the prehabilitation programme. Significant improvements were observed in VO2peak with 8 % (P = 0.001), 1-RM leg press with 20 % (p < 0.001) and Five-times Chair-Stand-Test with 0.5 s (p = 0.001). The number of patients at moderate to high risk of malnutrition significantly decreased after the programme, from 29 % to 19 % (p = 0.001). No changes in body composition and biomarkers were found.

Conclusion

This study demonstrates that multimodal prehabilitation has the ability to improve physical fitness and nutritional status preoperatively in gynaecological oncology patients. Further studies are needed to define the role of prehabilitation in improving physical fitness and nutritional status, and its association with postoperative outcomes, allowing for more personalized and effective treatment.

查看原文本刊更多论文

多模式康复方案对妇科癌症妇女术前身体健康和营养状况的影响

背景：妇科恶性肿瘤的手术治疗仍然与术后高发病率相关。多模式康复可以改善功能，从而减少手术相关的发病率。因此，本研究旨在评估多模式康复对妇科肿瘤患者体质和营养状况的影响。F4S-PREHAB试验是一项评估包括运动、营养、心理支持和戒酒在内的多模式康复效果的阶梯式试验，该试验对2022年5月至2024年4月在奈梅亨Radboudumc接受手术的妇科癌症患者进行了亚组分析。使用估计的峰值摄氧量、肌肉力量（间接1-重复最大（1-RM）腿部按压）、握力和五次椅站立测试来比较参与前后的身体健康。此外，还通过营养不良风险评估来评估营养状况。进一步的结果包括对身体成分和生物标志物（血红蛋白、白细胞、c反应蛋白、白蛋白）的影响。结果140名妇女接受了康复治疗。vo2峰值提高8% (P = 0.001)， 1-RM腿推提高20% (P < 0.001)， 5次椅站立测试提高0.5 s （P = 0.001）。中度至高度营养不良风险的患者数量在项目实施后显著下降，从29%降至19% （p = 0.001）。没有发现身体成分和生物标志物的变化。结论多模式康复可改善妇科肿瘤患者术前体质和营养状况。需要进一步的研究来确定康复在改善身体健康和营养状况方面的作用，以及它与术后结果的关系，从而允许更个性化和更有效的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy