Effectiveness of rehabilitation interventions in patients with colorectal cancer: an overview of systematic reviews.
Mengzhe Yang, Bhasker Amatya, Sana Malik and 4 others
PMID 39849998WHAT IT FOUND
Exercise and prehabilitation improve fitness and quality of life, but evidence for fatigue and mental health is weak.
Nutritional supplements cut surgical infections, while acupuncture speeds gut recovery. Results vary widely because studies used different doses and timelines, so no single best rehabilitation method was identified.
Key findings
01Multimodal prehabilitation before surgery improves preoperative functional capacity with high-quality evidence, but does not significantly reduce hospital length of stay.
02Nutritional interventions like immunonutrition and probiotics significantly reduce postoperative infectious complications with high-quality evidence, but have little effect on non-infectious complications or mortality.
03Exercise interventions improve physical fitness and quality of life with moderate-quality evidence, but evidence for reducing cancer-related fatigue and improving mental health is low or very low.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only English-language reviews were included, which may introduce selection bias. The methodological quality of the primary randomized controlled trials within the included reviews was not reassessed. There was marked heterogeneity in intervention types, doses, timings, and outcome measures across the reviews, preventing direct comparison and pooling of data. Many included reviews had search dates older than three years, potentially missing recent studies. Safety and adverse event data were incomplete or missing in many primary reviews. The analysis could not determine the optimal rehabilitation method or tailor findings to specific phases of cancer treatment due to lack of detail in primary studies.
Declared interests
The authors declared no conflicts of interest. The work was supported by the Department of Rehabilitation Medicine, Royal Melbourne Hospital, Australia.
The easy way to misread this
Do not interpret the moderate to high-quality evidence for specific outcomes as proof that a single rehabilitation protocol is superior. The overview found significant heterogeneity in how interventions were delivered, so the evidence supports the general category of intervention (e.g., exercise, nutrition) rather than a specific dose or duration. Additionally, do not assume all rehabilitation interventions reduce hospital length of stay or postoperative complications, as evidence for these outcomes was often low or very low quality.