Perioperative medicine & outcomes

Multimodal prehabilitation and perioperative immune function in patients undergoing abdominal cancer surgery

Br J SurgPublished Prospective substudy of the F4S PREHAB stepped-wedge trial

Authors' conclusion

This study suggests that multimodal prehabilitation influences basal immune function, leading to a less inflammatory state. However, as no significant differences in immune function were observed between the prehabilitation and control groups on POD1, the impact of prehabilitation on postoperative immune function may be limited.

Study context

Population
Patients undergoing elective bladder, oesophageal or rectal cancer surgery, June 2022–November 2023
Participants
130 patients
Comparison
Multimodal prehabilitation vs usual care
  • Prehabilitationn = 102
  • Controln = 28reference
Primary endpoint
Immune function (ex vivo cytokine production capacity, plasma cytokine concentrations, monocytic human leucocyte antigen DR (mHLA-DR) expression)
Follow-up
Baseline, after prehabilitation or usual care interval, and POD1
Methodological detailsexploratory
  • Exploratory

Primary result

As reported in the abstract

Preoperative immune function after prehabilitation · after the prehabilitation interval
  • Ex vivo production of pro-inflammatory cytokines reduced after prehabilitation
  • Ex vivo production of anti-inflammatory IL-10 increased after prehabilitation
  • Plasma IL-6 and IL-10 lower after prehabilitation
  • Exploratory

Further findings

Postoperative immune function · POD1

No significant differences between prehabilitation and control groups

Original publication

Multimodal prehabilitation and perioperative immune function in patients undergoing abdominal cancer surgery. Br J Surg. Published 6 June 2026. doi:10.1093/bjs/znag070

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