Multimodal Prehabilitation for Lung Cancer Surgery: A Randomized Controlled Trial

Abstract Background To determine whether a multimodal prehabilitation program enhances post-operative functional recovery compared to multimodal rehabilitation. Methods Patients scheduled for non-small cell lung cancer resection were randomized to two groups receiving home-based moderate intensity exercise, nutritional counseling with whey protein supplementation and anxiety reducing strategies, either for four weeks before (PREHAB, n=52) or 8 weeks after surgery (REHAB, n=43). Functional capacity (FC) was measured by the six-minute walk test (6MWT) at baseline, immediately prior to surgery, four and eight weeks after surgery. All patients were treated according to Enhanced Recovery Pathway (ERP) guidelines. Results There was no difference in FC at any time point during the perioperative period between the two multimodal programs. By eight weeks after surgery, both groups returned to baseline FC and a similar proportion of patients (over 75%) in both groups had recovered to their baseline. Conclusions In patients undergoing surgical resection for lung cancer within the context of ERP, multimodal prehabilitation initiated four weeks prior to surgery is as effective in recovering FC as multimodal rehabilitation.