PREDICTION OF PHYSICAL OUTCOMES OF THE MULTIMODAL PREHABILITATION PROGRAMME IN PATIENTS WITH COLORECTAL CANCER (PREDICT PREHAB)

Abstract

Title: Prediction of physical outcomes of the multimodal prehabilitation programme in patients with colorectal cancer (PREDICT PREHAB). Background: Worldwide, colorectal cancer (CRC) has a high incidence. To reduce the postoperative complication rate after CRC surgery, prehabilitation was introduced. Prehabilitation is defined as “the process of enhancing functional capacity of the individual to better withstand the stressor of inactivity”. It is unknown which CRC patients benefit most of the prehabilitation programme. Aim: To explore which patient factors can predict the physical outcome of a multimodal prehabilitation programme in preoperative patients with CRC. Methods: A retrospective, single-centre, observational cohort study, including all patients who completed the multimodal prehabilitation programme prior to colorectal tumor resection between October 2018 and March 2020 in a Dutch teaching hospital. The primary study outcome was the change in the six minute walk test (6MWT). The secondary study outcome was the change in the leg press one repetition maximum (1RM). Logistic regression was performed to identify predictors for the physical outcome of the programme. Results: In total, 89 patients were included in the data analysis. The median (IQR) change in the 6MWT and the 1RM were respectively 36 (39) meters and 21 (18) kilograms. The strongest predictor for a ≥50m change in 6MWT was alcohol consumption, corrected for American Society of Anaesthesiologists (ASA) grade. In the secondary outcome, the strongest predictor for a ≥20kg change in 1RM was the baseline 1RM, corrected for tumor location. Conclusion and implications of key findings: There were no statistically significant predictors of a ≥50m change in 6MWT. The results of this study should be interpreted with caution because of the small sample size. Alcohol cessation should be kept as part of the prehabilitation programme. Patients with an average baseline 1RM, might benefit more of the programme.