Finch Alice, Curry Jordan, Santhirakumaran Gowthanan, Alshdifat Saif, Jones Jack, Grant Duncan, Cooper Riley, Assadourian Anthony, Januszewski Adam, Jalali Sahra, Lau Kelvin, Ricketts William, Pompili Cecilia
Department of Physical Medicine, Rehabilitation and Sports Medicine, St Bartholomew's Hospital, London, UK.
Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
Interdiscip Cardiovasc Thorac Surg. 2025 Jun 4;40(6). doi: 10.1093/icvts/ivaf107.
We examined the impact of short-term, multimodal prehabilitation on perioperative functional and patient-reported outcomes (PROs) in patients undergoing surgical resection for non-small cell lung cancer (NSCLC).
This is a retrospective study with paired comparisons on consecutive patients worked up for surgical resection for suspected NSCLC referred for prehabilitation including exercise, nutritional, and PROs assessment in a single centre from October 2022 to August 2023. Patients participated in a hybrid programme, with twice-weekly, one-to-one sessions combing high-intensity interval-style and strength training with accompanying app-based exercise and lifestyle support. Functional outcomes were assessed via the 6-minute walk test (6MWT) and 1-minute sit-to-stand (1M-STS), and PROs were evaluated using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) and Patient-Generated Subjective Global Assessment (PG-SGA). A multivariable logistic regression analysis identified factors linked to significant PRO improvement.
During the study period, 85 patients were referred, with 98% consenting and 91% (75/85) completing a median of five sessions over 2.5 weeks, with 69% ultimately undergoing surgical resection. There was significant improvement in 6MWT distance (62.8 m, P < 0.001), 1M-STS (8.9 repetitions < 0.001), EQ-5D-5L (+6 points, P = 0.012) and PG-SGA nutritional status (-0.64 points, P = 0.044). Female sex, lower deprivation index (most deprived) and fewer sessions were associated with greater PRO improvements.
Short-term hybrid prehabilitation for resectable NSCLC improves patient functional and subjective outcomes, particularly among females and those from more deprived areas. This approach appears to enhance preoperative fitness and PROs for patients undergoing surgery potentially reducing postoperative complications and improving postoperative quality of life.
我们研究了短期多模式术前康复对接受非小细胞肺癌（NSCLC）手术切除患者围手术期功能和患者报告结局（PROs）的影响。
这是一项回顾性研究，对2022年10月至2023年8月在单一中心因疑似NSCLC接受术前康复（包括运动、营养和PROs评估）并准备进行手术切除的连续患者进行配对比较。患者参加了一个混合项目，每周两次一对一课程，将高强度间歇式和力量训练与基于应用程序的运动和生活方式支持相结合。通过6分钟步行试验（6MWT）和1分钟坐立试验（1M-STS）评估功能结局，使用欧洲五维健康量表（EQ-5D-5L）和患者主观整体评定法（PG-SGA）评估PROs。多变量逻辑回归分析确定了与PROs显著改善相关的因素。
在研究期间，共转诊85例患者，98%的患者同意参与，91%（75/85）的患者在2.5周内完成了中位数为5次的课程，最终69%的患者接受了手术切除。6MWT距离（62.8米，P<0.001）、1M-STS（8.9次，P<0.001）、EQ-5D-5L（+6分，P=0.012）和PG-SGA营养状况（-0.64分，P=0.044）均有显著改善。女性、较低的贫困指数（最贫困）和较少的课程次数与更大的PROs改善相关。
可切除NSCLC的短期混合术前康复可改善患者的功能和主观结局，尤其是女性和来自更贫困地区的患者。这种方法似乎可以提高手术患者的术前健康水平和PROs，可能减少术后并发症并改善术后生活质量。
