A prehabilitation intervention prior to colorectal cancer (CRC) surgery decreased postoperative complication rates, according to results of a randomized trial published in JAMA Surgery.

The PREHAB trial included 251 patients who were scheduled for surgical resection of primary CRC. They were randomly assigned to prehabilitation (123 patients) or standard care (128 patients).

The prehabilitation intervention consisted of a 4-week, personalized, in-hospital program encompassing smoking cessation, exercise, nutrition, and psychological support. The coprimary outcomes were 30-day postoperative complications and postoperative 6-minute walking distance.

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The rate of severe complications was significantly lower in the prehabilitation group than in the standard care group (odds ratio [OR], 0.47; 95% CI, 0.26-0.87; P =.02). The prehabilitation group had fewer medical complications than the standard group (OR, 0.48; 95% CI, 0.26-0.89; P =.02), but there was no significant difference in surgical complications.

There was no significant difference between the groups in 6-minute walking distance (P =.07), length of hospital stay (P =.20), or hospital readmission rate (P =.26). However, admission to the intensive care unit was significantly less frequent in the prehabilitation group (OR, 0.29; 95% CI, 0.09-0.89; P =.02).

The adverse event rate was 5.7% in the prehabilitation group. Adverse events consisted mainly of lightheadedness and nausea due to the exercise intervention or protein supplements.

“This PREHAB trial demonstrates the benefit of a multimodal prehabilitation program before colorectal cancer surgery as reflected by fewer severe and medical complications postoperatively and an optimized postoperative recovery compared with standard care,” the researchers wrote.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Molenaar CJL, Minnella EM, Coca-Martinez M, et al. Effect of multimodal prehabilitation on reducing postoperative complications and enhancing functional capacity following colorectal cancer surgery: The PREHAB randomized clinical trial. JAMA Surg. 2023;e230198. doi:10.1001/jamasurg.2023.0198

This article originally appeared on Oncology Nurse Advisor