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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 Royal College of Surgeons of England. All rights reserved.Introduction Studies have demonstrated that prehabilitation in oesophagogastric cancer (OGC) improves body composition, physical fitness and quality of life, and can reduce surgical complications. However, it is not offered in all OGC centres. Furthermore, definitions, funding and access to services vary. We conducted a survey of prehabilitation in OGC centres in England and Wales. Methods OGC centres were identified through the National Oesophago-Gastric Cancer Audit (NOGCA). Survey questions were developed, piloted in two institutions and distributed via email in October 2022. Reminder emails were sent over two months until the survey closed in December 2022. Results Responses were received from 28 of 36 centres. There was near-universal agreement that prehabilitation should be considered standard of care for patients on curative pathways (27/28; 96%). Most centres (21/28; 75%) offered prehabilitation. The majority of respondents believed that prehabilitation should commence at diagnosis (27/28; 96%) and consist of at least aerobic training and dietitian input. Most (26/28; 93%) believed access to clinical psychologists should be included; however, only 12 (43%) had access to clinical psychologists. Respondents believed prehabilitation improves quality of life (26/28; 93%), fitness (26/28; 93%), smoking cessation (28/28; 100%), surgical complication rates (25/28; 89.3%), likelihood of proceeding to surgery (25/28; 89.3%) and overall survival (20/28; 71.4%). Conclusions Despite barriers to funding and a lack of best practice guidelines, most units deliver prehabilitation. Units require higher quality evidence, consensus on the most important aspects of the intervention and core outcome sets to support the delivery of services and facilitate audit to assess the impact of their introduction.
Author(s): Barman S, Walker RC, Pucher PP, Jack S, Whyte G, Grocott MPW, West M, Maynard N, Underwood T, Gossage J, Davies A, Vohra R, Tang CB, Griffiths E, Tewari N, Moorthy K, Sultan J, Byrne B, Cheong E, Mercer S, Qureshi Y, Bowrey D, Phillips A, Kumar S, Turner P, Cockbain A, Jaunoo S, Sgromo B, Chana P, Priest O, Abdelrahman T, Chan D, Mukherjee D, Viswanath Y
Publication type: Article
Publication status: Published
Journal: Annals of the Royal College of Surgeons of England
Year: 2025
Volume: 107
Issue: 4
Pages: 300-306
Print publication date: 01/04/2025
Online publication date: 21/11/2024
Acceptance date: 28/09/2024
Date deposited: 14/04/2025
ISSN (print): 0035-8843
ISSN (electronic): 1478-7083
Publisher: Royal College of Surgeons of England
URL: https://doi.org/10.1308/rcsann.2024.0092
DOI: 10.1308/rcsann.2024.0092
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