Inclusion Criteria  Patients ,undergoing transthoracic esophagectomy (Ivor Lewis), in ≥ 4 weeks Age >65 years American Society of Anaesthesiologists - Score: 2-3 Ability to give informed consent Written informed consent  Exclusion Criteria:  Planned operation in less than 4 weeks after enrollment Urgent surgery indication Patients with good to excellent general and nutritional condition (0 points in the pre-screening of the modified NRS OR 1 point in the pre-screening and <2 points in the main screening). Patients deemed by the PAPRIKA team to be physically or mentally incapable of completing the exercise program.