Prehabilitation to enhance postoperative recovery for an octogenarian following robotic-assisted hysterectomy with endometrial cancer

Carli, Franco; Brown, Russell E.; Kennepohl, Stephan

doi:10.1007/s12630-012-9734-4

Cited by 64 publications

(50 citation statements)

References 20 publications

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“…Other studies have found that exercise in the prehabilitation period was feasible for sedentary individuals [39]. The results from a single-case report hinted that prehabilitation may be beneficial for elderly patients [40] which, in turn, supported the findings by Lai et al [17].…”

Section: Discussionsupporting

confidence: 69%

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

2017

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Purpose The purpose of the study is to systematically review and synthesise randomised controlled trials investigating the effectiveness of prehabilitation compared to usual care for newly diagnosed, adult-onset cancer patients. Methods MEDLINE, EMBASE, PsycINFO, CINAHL and SSCI were searched up to April 2017. Studies were included if disease-related, treatment-related, patient-reported and health service utilisation outcomes were assessed. Two reviewers independently reviewed and appraised the risk of bias of each study. Results Eighteen studies were included. Interventions comprised one or more of the following components: psychological support, education and exercise. Meta-analyses found that pelvic floor muscle training (PFMT) significantly increased odds of continence at 3 months (OR = 3.29, 95% CI = 1.57-6.91), but did not significantly reduce daily pad use at 6 months post-surgery Mean Difference (MD)= ( = − 0.96, 95% CI = − 2.04-0.12) for prostate cancer patients. Although quality of life improved due to PFMT, functional ability or distress did not. Further meta-analyses indicated that presurgical exercise significantly reduced length of hospital stay (MD = − 4.18, 95% CI = − 5.43-− 2.93) and significantly lowered odds of post-surgery complications (OR = 0.25, 95% CI = 0.10-0.66) for lung cancer patients. Psychology-based prehabilitation significantly improved mood, physical wellbeing and immune function for prostate cancer patients and improved fatigue and psychological outcomes and a trend for better quality of life among breast cancer patients. Risk of bias was high for most studies. Conclusions Prehabilitation appears to benefit cancer patients. Rigorous trials are needed to investigate the effectiveness of prehabilitation among other cancer sites and other related effects. The cost-effectiveness of prehabilitation remains unanswered. Implications for cancer survivors Providing interventions earlier in the care pathway may lead to better outcomes for patients during survivorship.

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Section: Discussionsupporting

confidence: 69%

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

2017

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“…We therefore recommend the assessment of prehabilitation programmes, comprising the optimisation of patients prior to surgical treatment, to improve modifiable risk factors. Although implementation remains a challenge because of a restricted time period between diagnosis and treatment, previous studies have shown promising results [31][32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

The impact of BMI on surgical complications and outcomes in endometrial cancer surgery—An institutional study and systematic review of the literature

Bouwman

Smits

Lopes

et al. 2015

Gynecologic Oncology

128

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“…It identifies potentially modifiable interventions to maximize independence, social support, cognition, and quality of life while reducing risks for poor outcomes such as delirium, worsening disability, post-operative complications, rehospitalization, or surgical mortality. 20, 21 The CGA identifies not only physical frailty but a wide variety of vulnerabilities. The CGA predicts post-surgical and overall mortality among patients with cancer, 9, 22, 23 and a pre-operative geriatric assessment improves surgical outcomes in patients with cancer.…”

Section: Importance Of the Frailty Syndrome Assessment To Cancer Carementioning

confidence: 99%

How should older adults with cancer be evaluated for frailty?

Huisingh-Scheetz

Walston

2017

Journal of Geriatric Oncology

103

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Traditionally used as a descriptive term, frailty is now a recognized medical syndrome identifying individuals with decreased physiologic reserve. Frailty is characterized by diminished strength, endurance, and reduced physiologic function. Several valid frailty screening tools exist in the literature, and these measures have been used to relate frailty to outcomes important to the older patient with cancer. Frail adults are at increased risk of adverse surgical outcomes and early findings suggest that frailty predicts poor chemotherapy tolerance. While much research is needed to explore the biologic relationships between frailty and cancer, there is an urgent need to implement frailty screening and management into the care of the older patient with cancer in order to improve outcomes in this vulnerable subset. The purpose of this paper is to provide an introduction of frailty to oncologists including a review of the definition, frailty screening tools, its clinical relevance to older patients with cancer, and a brief guide to frailty management.

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Prehabilitation to enhance postoperative recovery for an octogenarian following robotic-assisted hysterectomy with endometrial cancer

Cited by 64 publications

References 20 publications

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

The impact of BMI on surgical complications and outcomes in endometrial cancer surgery—An institutional study and systematic review of the literature

How should older adults with cancer be evaluated for frailty?

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