Perioperative medicine & outcomes
Supervised Multimodal Prehabilitation and Clinical Outcomes in Older Patients With Frailty and Gastric Cancer: The GISSG+2201 Randomized Clinical Trial
Authors' conclusion
Per the results of this randomized clinical trial, a multimodal prehabilitation program may enhance physiological reserve, reduce morbidity, and promote surgical resilience in older patients with frailty undergoing radical gastrectomy.
Study context
- Population
- Patients aged 65 to 85 years with frailty (Geriatric 8 score ≤14) scheduled for elective gastrectomy (± neoadjuvant chemotherapy), 15 centres in China347 in modified ITT
- Participants
- 368 patients
- Comparison
- Enhanced Recovery After Surgery (ERAS) care with vs without multimodal prehabilitation
- Prehabilitation group (PG)n = 169
- SGn = 178reference
- Primary endpoint
- Proportion of patients with postoperative complications
- Follow-up
- Within 30 days after surgery
Methodological detailsmulticentre, modified intention-to-treat, Overall compliance with prehabilitation 93.75%
- Multicentre
- Modified intention-to-treat
- Overall compliance with prehabilitation 93.75%
Primary result
As reported in the abstract
P = 0.01
Secondary outcomes
Minor complications
P = 0.01
Medical complications
P = 0.02
- 6-minute walk test change, preoperative vs baseline (PG) · before surgery
- +24 · mean · SD 12.5 · m
6-minute walk test change, preoperative vs baseline (PG) · before surgery
- Increased functional capacity before surgery vs baseline in PG (P < .001)
- Mean walking distance of PG remained above baseline 4 weeks after surgery
Inflammation, preoperative physical QoL, ICU LOS, mechanical ventilation time, hospital LOS
- Generally favoured prehabilitation vs standard ERAS care
Original publication
Supervised Multimodal Prehabilitation and Clinical Outcomes in Older Patients With Frailty and Gastric Cancer: The GISSG+2201 Randomized Clinical Trial. JAMA Surg. Published 1 March 2026. doi:10.
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