Geriatric prehabilitation prior to surgery for kidney tumors: Study protocol for Pre-KiT - A randomized controlled trial

IF 2.9 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology Pub Date : 2026-03-01 Epub Date: 2026-01-26 DOI:10.1016/j.jgo.2026.102893

Marie Juul-Haslund , Cecilia M. Lund , Troels G. Dolin , Katrine Schou-Jensen , Peter B. Østergren , Anders Vinther , Frederik F. Thomsen , Mikkel Fode

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引用次数: 0

Abstract

Introduction

Renal cell carcinoma (RCC) primarily affects older adults who often present with frailty, increasing their risk of surgical complications and delayed recovery. Prehabilitation, incorporating exercise, nutrition, and psychological support, may improve postoperative outcomes. However, no studies have investigated prehabilitation prior to surgery for RCC. The aim is to assess whether a one-month multimodal prehabilitation program including geriatric interventions improves recovery in patients with frailty undergoing surgery for localized RCC ≤ 7 cm.

Materials and methods

60 patients, aged ≥65, with a Clinical Frailty Scale (CFS) score of 3–6 are randomized 1:1 to standard care or prehabilitation involving home-based exercise, geriatric assessment with tailored interventions, and smoking cessation support. The primary outcome is change in Quality of Recovery-15 (QoR-15) 21 days postoperatively. Secondary outcomes include changes in QoR-15, health-related quality of life (EQ-5D-5L) and physical performance (30-s chair-stand test, handgrip strength) assessed preoperatively, 1, 21 and 90 days postoperatively. Postoperative complications will be evaluated using the Clavien-Dindo classification, alongside a cost-effectiveness analysis. Long-term outcomes include 1- and 5-year recurrence-free, cancer-specific, and overall survival.

Discussion

Pre-KiT explores if a pragmatic geriatric prehabilitation strategy is effective and feasible for older frail patients with RCC. The intervention is designed for easy implementation in clinical practice: administered by a single healthcare professional, requiring only one additional hospital visit, and consists of home-based exercises. This low-resource approach also aims to minimize financial costs, which is of importance for implementation possibilities. If successful, it could improve standard care and outcomes after surgery.

Trial registration: ClinicalTrials.gov ID: NCT06745609. Prospectively registered December 12th, 2024.

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肾脏肿瘤手术前的老年康复：Pre-KiT的研究方案-一项随机对照试验。

肾细胞癌（RCC）主要影响老年人，他们经常表现出虚弱，增加了手术并发症和延迟恢复的风险。康复训练，包括运动、营养和心理支持，可以改善术后预后。然而，没有研究调查RCC手术前的康复。目的是评估包括老年干预在内的为期一个月的多模式康复计划是否能改善因局限性RCC≤7 cm而接受手术的虚弱患者的康复。材料和方法：60例年龄≥65岁，临床虚弱量表（CFS）评分为3-6分的患者，以1:1的比例随机分为标准治疗或康复治疗，包括基于家庭的锻炼、定制干预的老年评估和戒烟支持。主要观察指标为术后21天恢复质量-15 （QoR-15）的变化。次要结局包括术前、术后1、21和90天评估的QoR-15、健康相关生活质量（EQ-5D-5L）和身体表现（30秒椅架测试、握力）的变化。术后并发症将使用Clavien-Dindo分类进行评估，并进行成本-效果分析。长期预后包括1年和5年无复发、癌症特异性和总生存期。讨论：Pre-KiT探讨了一种实用的老年康复策略对患有肾细胞癌的老年体弱患者是否有效和可行。该干预措施旨在便于在临床实践中实施：由一名保健专业人员管理，只需要一次额外的医院就诊，并包括以家庭为基础的练习。这种低资源方法还旨在尽量减少财政成本，这对执行的可能性很重要。如果成功，它可以改善手术后的标准护理和结果。试验注册：ClinicalTrials.gov ID: NCT06745609。预计于2024年12月12日注册。

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

Journal of geriatric oncology ONCOLOGY-GERIATRICS & GERONTOLOGY

CiteScore

5.30

自引率

10.00%

发文量

379

审稿时长

80 days

期刊介绍： The Journal of Geriatric Oncology is an international, multidisciplinary journal which is focused on advancing research in the treatment and survivorship issues of older adults with cancer, as well as literature relevant to education and policy development in geriatric oncology. The journal welcomes the submission of manuscripts in the following categories: • Original research articles • Review articles • Clinical trials • Education and training articles • Short communications • Perspectives • Meeting reports • Letters to the Editor.