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Preoperative Optimisation in Patients Undergoing Cancer Surgery: 2nd Edition

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 10 July 2026 | Viewed by 2152

Special Issue Editors


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Guest Editor
1. Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia
2. Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia.
Interests: prehabilitation; patient screening; clinical trials; decision-making; effectiveness; cost-effectiveness; patient reported outcomes; quality of life; surgical outcomes; cancer surgery
Special Issues, Collections and Topics in MDPI journals
1. Colorectal Surgeon, Royal Prince Alfred Hospital, Syndey, Australia
2. Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia.
Interests: surgical approach; decision making; patient selection; surgical outcomes; colorectal cancer; minimally invasive surgery; complex surgery; patient reported outcomes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

For selected patients presenting with cancer, surgery with or without chemoradiotherapy is the mainstream treatment option, with the primary aim of removing all cancer cells. Despite the improved survival benefits, postoperative morbidity is still high. This slows the recovery period, with some patients needing to stay in hospital for a longer period of time, and this has the potential to adversely affect the patient’s quality of life.

Recently, prehabilitation was introduced to enhance general health and wellbeing before cancer surgery. There is some evidence suggesting that preoperative medical, physical, nutritional, and psychological interventions may reduce postoperative morbidity rates, facilitate recovery, and improve subsequent quality of life. However, the evidence around the effectiveness of preoperative optimisation is still in an embryonic phase. It is also unclear if preoperative patient optimisation should be offered more selectively to at-risk patient cohorts.

Thus, this Special Issue will cover all aspects of preoperative optimisation, including but not limited to the following:

  1. Original studies or systematic reviews evaluating the effectiveness of preoperative interventions (medical, physical, nutritional, and psychological) on reducing postoperative outcomes and length of hospital stay and improving quality of life in patients undergoing cancer surgery;
  2. Measures of association between preoperative factors (medical, physical, nutritional, and psychological) and postoperative surgical outcomes;
  • Evidence gaps in prehabilitation, including research priorities and limitations of the current evidence;
  1. Applicability of different prehabilitation modes, including telehealth interventions.

You are welcome to read the published papers in the first edition of this Special Issue: Preoperative Optimisation in Patients Undergoing Cancer Surgery.

Dr. Daniel Steffens
Dr. Cherry Koh
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prehabilitation
  • medical optimization
  • exercise
  • nutrition
  • psychological interventions
  • surgery
  • cancer
  • surgical outcome
  • preoperative
  • clinical trials

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Published Papers (2 papers)

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16 pages, 745 KB  
Article
Preoperative Cachexia as a Predictor of Postoperative Morbidity and a Target for Home-Based Prehabilitation in Resectable Gastric Cancer
by Vladimir Konstantinovich Lyadov, Tatiana Sergeevna Boldyreva, Alexander Yuryevich Gorshkov, Elena Vitalievna Zyatenkova, Anna Yurievna Ikonnikova, Mikhail Georgievich Chashchin and Vsevolod Nikolaevich Galkin
Cancers 2026, 18(2), 324; https://doi.org/10.3390/cancers18020324 - 20 Jan 2026
Cited by 1 | Viewed by 715
Abstract
Background: Gastric cancer (GC) is one of the most common malignancies, requires aggressive treatment, as has a high incidence of complications. The high prevalence of cachexia and comorbidity among GC patients has led to the development of the “prehabilitation” concept. We aimed to [...] Read more.
Background: Gastric cancer (GC) is one of the most common malignancies, requires aggressive treatment, as has a high incidence of complications. The high prevalence of cachexia and comorbidity among GC patients has led to the development of the “prehabilitation” concept. We aimed to investigate the prognostic value of cachexia in the “Western” patient population with resectable GC and to evaluate its utility as an indicator for a home-based prehabilitation program. Methods: This cohort study included 147 patients who underwent surgical treatment for GC from 2019 to 2023. A multivariable analysis was conducted to study the impact of cachexia on postoperative outcomes in 122 patients with resectable GC. The prehabilitation group included 25 patients with cachexia who underwent a 2-week-long multimodal prehabilitation program prior to surgery. The functional results, as well as the 30-day incidence of postoperative complications and 90-day mortality, were evaluated. Results: There were 76 (51.7%) patients with cachexia. Multivariate analysis revealed that cachexia was a significant predictor of all postoperative complications (OR = 5.48, 95% CI 1.85–18.39, p = 0.001), severe postoperative complications (OR = 15.87, 95% CI 3.05–131.81, p < 0.001) and surgical site infection (SSI) (OR = 8.03, 95% CI 1.89–49.09, p = 0.038). Patients in the prehabilitation group had a lower incidence of SSI than in the control group (8.3% vs. 23.5%, p = 0.049). Conclusions: Preoperative cachexia is a potentially modifiable predictor of complications after gastric cancer surgery, and its identification may help define high-risk patients for proactive multimodal prehabilitation. Full article
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33 pages, 1805 KB  
Systematic Review
Technology-Enabled (P)rehabilitation for Patients Undergoing Cancer Surgery: A Systematic Review and Meta-Analysis
by Tiffany R. Tsoukalas, Zirong Bai, Claire Jeon, Roy Huynh, Eva Gu, Kate Alexander, Paula R. Beckenkamp, Adrian Boscolo, Kilian Brown, Phyllis Butow, Sharon Carey, Fang Chen, Meredith Cummins, Haryana M. Dhillon, Vesna Dragoje, Kailey Gorman, Matthew Halpin, Abby Haynes, Ilona Juraskova, Sascha Karunaratne, Jamie Keck, Bora Kim, Cherry Koh, Qiang Li, Lara Lipton, Xiaoqiu Liu, Jaime Macedo, Rebecca Mercieca-Bebber, Renee Moreton, Rachael L. Morton, Julie Redfern, Bernhard Riedel, Angus Ritchie, Charbel Sandroussi, Cathy Slattery, Allan Ben Smith, Michael Solomon, Flora Tao, Kate White, Kate Wilson, Kahlia Wolsley, Kun Yu and Daniel Steffensadd Show full author list remove Hide full author list
Cancers 2026, 18(2), 296; https://doi.org/10.3390/cancers18020296 - 18 Jan 2026
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Abstract
Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity [...] Read more.
Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59–2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40–8.84; four trials), depression (MD = 2.82; 95% CI: 0.65–4.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97–13.23; three trials) and distress (MD = 1.23; 95% CI: 0.30–2.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies. Full article
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