What is the role of physical exercise in the era of cancer prehabilitation? A systematic review
Nicole Del Bianco, Anita Borsati, Linda Toniolo, Christian Ciurnielli, Lorenzo Belluomini, Jessica Insolda, Marco Sposito, Michèle Milella, Federico Schena, Sara Pilotto, Alice Avancini
Abstract
Exercise before surgery, as part of prehabilitation, aiming to enhance patients' functional and physiological capacity, has become widespread, necessitating an in-depth understanding. A systematic search was conducted on Pubmed, Cochrane, and Scopus to examine the effect of exercise as prehabilitation, alone or in combination with other interventions, in patients with cancer. Interventional studies applying a single-arm, randomized controlled, or nonrandomized design were included. A total of 96 studies were included, and categorized according to cancer types, i.e., gynecological, breast, urological, gastrointestinal and lung cancer. For each cancer site, the effect of exercise, on physical fitness parameters and postoperative outcomes, including length of hospital stay and postoperative complications, was reported. Exercise as prehabilitation may have an important role in improving physical fitness, postoperative outcomes, and accelerating recovery, especially in certain types of malignancies. • Exercise prior to surgery may influence postoperative outcomes in cancer. • Evidence for breast, gynecological, and urological cancers is still limited. • Exercise may improve postoperative outcomes in esophagogastric and lung cancer. • Exercise may exert a synergist role with neoadjuvant treatments.