My-PEP: a prehabilitation intervention in oesophaseal cancer patients

Abstract

Increasing physical fitness prior to oesophageal cancer resection surgery (oesophagectomy), through an exercise prehabilitation programme with a theoretical understanding of behaviour and behavior change, has the potential to decrease postoperative complication risk. The purpose of this paper is to present feasibility data of a preoperative personalised programme (my-PEP) for adults with oesophageal adenocarcinoma. A single centre, parallel group, single-blinded, randomized controlled trial was carried out to produce primary (e.g. recruitment, safety) and secondary (e.g. physical activity, physiological fitness, cardiopulmonary complications) outcomes. My-PEPconsisted of a 4-week exercise programme (with sessions hospital-supervised and home-based) tailored to patient’s capability, opportunity and motivation needs. Standard care was home exercise advice only. During 9 months 20 patients were screened, 11 (55%) were randomised (5 to the prehabilitation group, 6 to the control group) and completed the trial (100% retention). In the prehabilitation arm there was full attendance to hospital sessions but adherence to home exercise sessions was low (25% to 49%) mostly due to side effects of chemotherapy. There were no adverse reactions reported in either arm to exercise. No statistically differences were found between arms regarding secondary outcomes. This trial provides ‘proof of concept’ for my-PEP and informs the design of a larger feasibility study.