Feasibility of Introducing a Prehabilitation Program into the Care of Gynecological Oncology Patients—A Single Institution Experience

Simple Summary Surgery is the cornerstone in the treatment of most gynecological cancers and is associated with significant risks. Gynecological cancer patients are generally elderly, overweight, and have a sedentary lifestyle, which are all factors associated with surgical complications. Prehabilitation entails the optimizing of a patient’s condition prior to surgery, and has been introduced with the goal of improving postoperative outcomes and recovery. A prehabilitation program has been implemented at an academic hospital in The Netherlands and comprises a physical exercise intervention, nutritional intervention, psychological intervention, and an intoxication cessation program. In this study, we assessed the feasibility of this program in terms of recruitment, adherence, and safety of implementation into the standard care of gynecological oncology patients. The principal finding was that the implementation of a prehabilitation program for gynecological oncology patients is feasible, with high recruitment and adherence rates. In addition, we did not encounter any major adverse events, suggesting its safety. Abstract Prehabilitation is an upcoming strategy to optimize patient’s functional capacity, nutritional status, and psychosocial well-being in order to reduce surgical complications and enhance recovery. This study aims to assess the feasibility of implementing a multimodal prehabilitation program into the standard care of gynecological oncology patients at an academic hospital in terms of recruitment, adherence, and safety, which were assessed by the number of patients eligible, recruitment rate, participation rate, and adherence to individual modalities. Data were derived from the F4S PREHAB trial, a single-center stepped-wedge trial implementing a multimodal prehabilitation program among various surgical specialties. All patients undergoing elective surgery as part of treatment for ovarian, uterine, and vulvar cancer at the Radboudumc, an academic hospital in The Netherlands, between May 2022 and September 2023 were considered eligible for the F4S PREHAB trial and, consequently, were included in this cohort study. The multimodal prehabilitation program comprised a physical exercise intervention, nutritional intervention, psychological intervention, and an intoxication cessation program. A total of 152 patients were eligible and approached for participation of which 111 consented to participate, resulting in a recruitment rate of 73%. Participants attended an average of six exercise sessions and adhered to 85% of possible training sessions. Respectively, 93% and 98% of participants adhered to the prescribed daily protein and vitamin suppletion. Ten participants were referred to a psychologist and completed consultations. Out of nine active smokers, two managed to quit smoking. A total of 59% adhered to alcohol cessation advice. No adverse events were reported. This study demonstrates that introducing a multimodal prehabilitation program into the standard care of gynecological oncology patients is feasible in terms of recruitment and adherence, with no serious adverse events.