{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:32:24Z","timestamp":1792053144720,"version":"4.4.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fresenius Kabi Australia Pty Limited"},{"name":"Concord Cancer Centre, Concord Repatriation General Hospital, Australia"},{"DOI":"10.13039\/501100001774","name":"University of Sydney","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001774","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Surgery remains the primary treatment for early-stage colorectal and upper gastrointestinal (UGI) cancers. However, it can lead to postoperative complications and reduced functionality. Prehabilitation aims to improve functional reserves before surgery. We aimed to evaluate the implementation of a multimodal prehabilitation program in \u201creal-world\u201d patients undergoing gastrointestinal cancer surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>An implementation study evaluating prehabilitation in patients undergoing gastrointestinal (colorectal or UGI) cancer surgery at Concord Hospital. The prehabilitation program included supervised exercise, nutrition and nursing support delivered face-to-face or by telehealth (COVID-19 adaptations). Assessments: baseline, pre-surgery and 30 days after surgery. Primary outcome: implementation using the RE-AIM (Reach\/Effectiveness\/Adoption\/Implementation\/Maintenance) framework. Secondary outcomes: functional, nutritional and surgical outcomes, with comparisons to historical controls.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Between January 2020 and December 2021, 181 patients were screened; 91 (50%) were eligible. Reach: 77\/91 recruited (63 colorectal, 14 UGI). Median age, 70 years (IQR, 59\u201379); 60% were males. Median intervention duration, 16 days (IQR, 12.25\u201319.75). Effectiveness: quality of life, anxiety and functional capacity improved from baseline to pre-surgery (6-min walk test (+16.1 m, <jats:italic>p<\/jats:italic>=0.038) and 2-min step test (+10.0 steps, <jats:italic>p&lt;0.001<\/jats:italic>)). Compared to historical controls, hospital length of stay was reduced by 2.1 days (<jats:italic>p<\/jats:italic>=0.010), with no differences in complications. Adoption: 91% of referrals came directly from surgeons. Implementation: 94% completed the intervention, with high adherence and satisfaction levels. Maintenance: after study completion, the program was incorporated into standard care with some modifications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Prehabilitation can be implemented in a real-world setting, with a trend towards improving functional and surgical outcomes, but dedicated resources are necessary to implement and maintain the program.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00520-025-09496-5","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T10:25:35Z","timestamp":1746699935000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Moving from theory to practice: implementing a prehabilitation program before gastrointestinal cancer surgery (PREHAB-GI)"],"prefix":"10.1007","volume":"33","author":[{"given":"Kristy-Lee","family":"Raso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Suen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Egger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Khatri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanlan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Wildbore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caoimhe","family":"Scales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Gerber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kin Yin Carol","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Becerril-Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Le Page","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sim Yee Cindy","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janette","family":"Vardy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"issue":"1","key":"9496_CR1","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/S1470-2045(18)30646-6","volume":"20","author":"S Benitez Majano","year":"2019","unstructured":"Benitez Majano S, Di Girolamo C, Rachet B, Maringe C, Guren MG, Glimelius B et al (2019) Surgical treatment and survival from colorectal cancer in Denmark, England, Norway, and Sweden: a population-based study. 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Permission was granted to obtain the data for the historical control group from the Bowel Cancer Database (HREC: 16\/CRGH\/263). A waiver of consent was obtained, as participants had consented to the use of their de-identified data in other research studies. The study was conducted in accordance with the principles of the Declaration of Helsinki (2013).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Prehab-GI participants received a Participant Information Sheet outlining the study details. Written consent was obtained prior to the commencement of the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All PREHAB-GI participants received a Participant Information Sheet explaining publication and confidentiality information. Written consent was obtained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"KLR and the Concord Repatriation General Hospital Nutrition and Dietetics department disclose that funding was received for a part-time wage for one year from Fresenius Kabi to support the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"458"}}