Addition of the nutrition factor enhances the cancer prehabilitation program design for colorectal cancer patients: a multi-center cohort study.
Tsuyoshi Hara, Eisuke Kogure, Shinno Iijima and 3 others
PMID 38075511WHAT IT FOUND
Before colorectal surgery, higher serum albumin was linked to lower postoperative inflammation and shorter stay, while higher vitality was linked to shorter stay.
No prehabilitation program was tested, so these are associations.
Key findings
01In the model, higher baseline skeletal muscle index was directly related to higher C-reactive protein on postoperative day 3 (standardized total effect 0.411), while higher serum albumin was directly related to lower C-reactive protein (standardized total effect -0.273).
02Higher baseline vitality was directly related to shorter length of hospital stay (standardized total effect -0.158).
03Serum albumin was directly related to 6-minute walk distance (standardized total effect 0.359), and mental health was directly related to vitality (standardized total effect 0.652).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was an observational cohort, not a trial of cancer prehabilitation, so it cannot show that exercise, nutrition, or mental care caused better postoperative course. Of 232 patients approached, 127 were enrolled, and 82 were excluded for incomplete data, which may leave a selected group. All participants were of Japanese descent. The study used only day 3 C-reactive protein to represent early postoperative immune response. Other perioperative factors were not examined. The authors note possible selection bias, especially for clinical stage IV cancer, and state that the model did not include demographics and clinical data except age and sex.
Declared interests
Funded by Grants-in-Aid for Scientific Research, grant no. 19K19880, from the Japan Society for the Promotion of Science. The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that adding nutrition or exercise to prehabilitation will reduce inflammation, complications, or hospital stay. The study did not deliver a cancer prehabilitation program; it only observed associations between baseline measures and postoperative course.