Endurance training alone was found to increase both lower extremity strength and endurance capacity .
Colorectal cancer surgery results in considerable postoperative morbidity , mortality and reduced quality of life .
As many patients will undergo additional (neo)adjuvant therapy , it is imperative that each individual optimize their physical function .
To eluci date the potential of exercise in patient optimization , we investigated the evidence for an exercise program before and after surgical treatment in colorectal cancer patients .
Preoperative modifiable risk factors in colorectal surgery: an observational cohort study identifying the possible value of prehabilitation
Abstract Background : Colorectal cancer ( CRC ) is the second most prevalent type of cancer in the world . Surgery is the most common therapeutic intervention , and associated with 20–40 % reduction in physiological and functional capacity . Postoperative complications occur in up to 50 % of patients result ing in higher mortality rates and greater hospital costs . The number and severity of complications is closely related to patients ’ preoperative performance status . The aim of this study was to identify the most important preoperative modifiable risk factors that could be part of a multimodal prehabilitation program . Methods : Prospect ively collected data of a consecutive series of Dutch CRC patients undergoing colorectal surgery were analyzed . Modifiable risk factors were correlated to the Comprehensive Complication Index ( CCI ) and compared within two groups : none or mild complications ( CCI < 20 ) , and severe complications ( CCI ≥20 ) . Multivariate logistic regression analysis was done to explore the combined effect of individual risk factors . Results : In this 139 patient cohort  , smoking , malnutrition , alcohol consumption , neoadjuvant therapy , higher age , and male sex , were seen more frequently in the severe complications group ( CCI ≥20 ) . Patients with severe complications had significantly longer hospital stay ( 16 vs. 6 days , p < 0.001 ) . The risk for severe complications was increased in patients with ASA score III [ adjusted odds ratio ( OR ) 4.4 , 95 % CI 1.04–18.6 ] , and hemoglobin level < 7 mmol/l ( adjusted OR 3.3 , 95 % CI 1.3–8.2 ) . Compared to having no risk factors , more than one risk factor increased OR of severe complications ( crude OR 5.2 , 95 % CI 1.8–15 ) . Conclusion : This study revealed that the risk of getting severe complications increases with the number of risk factors present preoperatively . Several preoperative patient-related risk factors are modifiable . Multimodal prehabilitation may improve patients ’ preoperative status and should be tested in a multicenter r and omized controlled trial . With an international consortium ( Copenhagen , Montreal , Paris , Eindhoven ) we initiated a r and omized controlled trial ( NTR5947 )
Endurance training alone was found to increase both lower extremity strength and endurance capacity .
Colorectal cancer surgery results in considerable postoperative morbidity , mortality and reduced quality of life .
As many patients will undergo additional (neo)adjuvant therapy , it is imperative that each individual optimize their physical function .
To eluci date the potential of exercise in patient optimization , we investigated the evidence for an exercise program before and after surgical treatment in colorectal cancer patients .