Perioperative medicine & outcomes
Home-based exercise prehabilitation to improve disease-free survival and return to intended oncologic treatment after cancer surgery in older adults with frailty: a secondary analysis of a randomized trial
Primary result · Death or cancer recurrence (1-yr disease-free survival)Result — go to the resultHR for death or cancer recurrence 1.25 95% CI 0.66–2.34Authors' conclusion
Randomization to home-based exercise prehabilitation did not lead to significantly better disease-free survival or earlier return to intended oncologic treatment in older adults with frailty undergoing cancer surgery.
Study context
- Population
- Patients ≥ 60 yr with frailty undergoing elective cancer surgery182 in modified ITT
- Participants
- 204 patients
- Comparison
- Prehabilitation vs Usual care
- Prehabilitationn = 102
- Usual caren = 102reference
- Primary endpoint
- Disease-free survival and return to intended oncologic treatment
- Follow-up
- One year
Methodological detailsmodified intention-to-treat, complier average causal effects
- Modified intention-to-treat
- Complier average causal effects
Primary result
As reported in the abstract
Death or cancer recurrence (1-yr disease-free survival) · 1 yr
HR for death or cancer recurrence
1.25
95% CI 0.66–2.34
P = 0.49
Events by treatment group
Prehabilitation vs Usual care
HR for death or cancer recurrence 1.25 (95% CI 0.66–2.34); P = 0.49
Further findings
| Outcome | Prehabilitation | Usual care | HR for return to intended oncologic treatment (95% CI) | P value | |
|---|---|---|---|---|---|
| Return to intended oncologic treatmentModified ITT population | 29% | 23% | 1.53 (0.84–2.77) | P = 0.16 | |
| 0.20.5125HR for return to intended oncologic treatment (log scale) |
Disease-free survival, complier average causal effect
- Complier average causal effect HR for disease-free survival (95% CI 0.20 to 4.08; P = 0.90); CI included 1
- 0.91
- Complier average causal effect, accounting for intervention adherence
Return to intended oncologic treatment, complier average causal effect
- Complier average causal effect HR for return to treatment (95% CI 0.52 to 7.97; P = 0.30); CI included 1
- 2.04
- Complier average causal effect, accounting for intervention adherence
Original publication
Home-based exercise prehabilitation to improve disease-free survival and return to intended oncologic treatment after cancer surgery in older adults with frailty: a secondary analysis of a randomized trial. Can J Anaesth. Published 5 September 2024. doi:10.
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