Fit4Surgery: A pilot randomized controlled trial to assess the feasibility of prehabilitation prior to debulking surgery for ovarian cancer

Objectives

To assess the feasibility of enrolling women with ovarian cancer in a randomized controlled trial (RCT) of a home-based, patient-tailored physical activity prehabilitation program (Fit4Surgery, F4S) and assess adherence while estimating effects on patient-reported outcomes (PROs), frailty, and physical function.

Methods

Thirty patients aged ≥60 with ovarian cancer, scheduled for neoadjuvant chemotherapy and surgery, were randomized 2:1 to Fit4Surgery or educational control. The intervention group received a Fitbit, access to the F4S app, and weekly coaching calls. Controls received educational calls and access to the Cancer.Net app. The primary outcome was feasibility, defined as >80 % evaluability and adherence. Daily steps and PROs were compared using paired t-tests or Wilcoxon rank sum tests.

Results

Of 74 patients approached, 32 consented and 30 were randomized. Average age was 69.7 years (range 60–81). Ninety percent of patients completed both baseline and pre-surgical assessments. Patients wore their FitBit on 94 % of days, attended 97 % of coaching calls, and engaged with the F4S app on 80 % of days. Patients reached personal step goals on 49 % of days, while 77.8 % of patients increased their daily steps over the intervention, with an average increase of 1804 steps per day (37 % increase, p = 0.01). Patient-reported physical function (p = 0.09) and frailty-related metrics, including energy levels (p = 0.01) and weekly walks (p = 0.02) improved in the F4S group, while no differences were detected in surgical outcomes.

Conclusions

Fit4Surgery was feasible with high engagement and adherence. Patients demonstrated increased daily step count and positive trends in PROs, frailty, and physical function.