Effect of short-term exercise-based prehabilitation program for patients undergoing liver cancer surgery: A randomized controlled trial.

Background: Patients with liver cancer usually experience postoperative complications and reduced perioperative functional capacity. This study aimed to assess the effect of a short-term, exercise-based prehabilitation program on postoperative clinical outcomes and perioperative functional capacity in patients with liver cancer undergoing hepatectomy.

Methods: This single-center, prospective, open-labeled randomized controlled trial was conducted with 205 patients. Patients in the prehabilitation group (n = 104) received a 1-week exercise intervention program before surgery, including aerobic and resistance exercises, and respiratory training. Patients in the control group (n = 101) received the usual clinical care. The assessors were blinded to the patient allocation. The primary outcome was the incidence of postoperative pulmonary complication during hospitalization, which the multivariate logistic regression model analyzed. Other outcomes included functional capacity measured as the 6-minute walk distance, postoperative complications, length of stay, hospital readmissions, hospitalization cost, and patient-reported outcomes. Post hoc subgroup analyses were performed.

Results: The median duration of prehabilitation was 8 days. There was no between-group difference in the incidence of postoperative pulmonary complication (adjusted odds ratio, 0.70; 95% confidence interval, 0.37-1.29; P = .249). There were no differences in postoperative clinical outcomes and patient-reported outcomes, except for 6-minute walk distance (33.36 m higher in the prehabilitation group, 95% CI, 22.02-44.70; P < .001).

Conclusion: This exercise prehabilitation program did not affect postoperative clinical outcomes or patient-reported outcomes of patients with liver cancer, but it showed improvement in preoperative functional capacity.