Clinical application of cancer prehabilitation program in pancreatic cancer patients undergoing surgery: A single-center historical control, quasi-experimental study

Background Cancer prehabilitation is a preoperative intervention involving nutrition, exercise, and psychological measures from diagnosis to the beginning of treatment, which can improve postoperative outcomes.

Objective To explore the application effect of cancer prehabilitation in pancreatic cancer patients undergoing surgery.

Methods Patients undergoing pancreatic cancer surgery admitted to hospital from July 2022 to February 2023 were recruited as the study objects, among which patients admitted from July to October 2022 were included in the control group, and patients admitted from November 2022 to February 2023 were included in the prehabilitation group. The control group received routine preoperative intervention, and the prehabilitation group received cancer prehabilitation on the basis of the control group, including nutritional support, exercise inter-vention and psychological nursing. The 6-minute walking test (6MWT), Nutrition Risk Screening 2002 (NRS2002), body mass index (BMI), the Hospital Anxiety and Depression Scale (HADS) at 1 day before surgery and early postoperative recovery indicators were compared between the two groups.

Results A total of 47 patients were included, including 23 cases in the control group and 24 cases in the prehabilitation group. There was no significant difference in baseline general information such as age and gender between the two groups (P > 0.05). In the prehabilitation group, the 6MWD (508.75 ± 56.57 m vs 464.35 ± 60.78 m), NRS2002 (2.50 ± 0.78 vs 3.13 ± 1.22), BMI (24.53 ± 1.43 kg/m² vs 22.35 ± 3.05 kg/m²), HADS-A (3.13 ± 1.99 vs 5.35 ± 1.85), HADS-D (2.96 ± 2.49 vs 4.70 ± 1.96) at 1 day before surgery were superior to control group, the differences were statistically significant (P < 0.05). The off-bed time (38.29 ± 2.46 h vs 40.39 ± 2.76 h), the first time to exhaust (59.13 ± 3.66 h vs 61.74 ± 3.44 h), the time to defecate (71.00 ± 4.74 h vs 74.87 ± 3.70 h) were improved compared with the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in postoperative hospital stay between the two groups (P > 0.05). None of the patients had any adverse events such as fall or cardiac and respiratory arrest.

Conclusion Cancer prehabilitation is effective in improving motor function, nutritional status and psychological state of pancreatic cancer patients and promoting postoperative recovery.