{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:42:17Z","timestamp":1786117337316,"version":"build-2736575974"},"reference-count":54,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Natural Science Foundation of Hubei Province of China","award":["2024AFB860"],"award-info":[{"award-number":["2024AFB860"]}]},{"name":"the Natural Science Foundation of Hubei Province of China","award":["2023AFB910"],"award-info":[{"award-number":["2023AFB910"]}]},{"name":"Internal Science Research Fund of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology","award":["2023XHYN077"],"award-info":[{"award-number":["2023XHYN077"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,22]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>A growing body of evidence supports prehabilitation in cancer patients, but the findings have been inconsistent. This overview aimed to identify, evaluate and summarise the effect of prehabilitation on the clinical outcomes of cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Overview of systematic reviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library and the JBI Evidence Synthesis database (Joanna Briggs Institute, University of Adelaide, Australia; hosted on Ovid) were searched from inception to January 2025. The search was updated in May 2026, and no new articles were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>We included systematic reviews of randomised controlled trials (RCTs) involving adult cancer patients with a clinically established diagnosis who received prehabilitation interventions prior to surgical treatment. We excluded abstract-only citations, narrative reviews and scoping reviews. Reviews were excluded if \u226550% of the included studies were postoperative interventions, or if preoperative subgroup data could not be extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Two reviewers independently extracted data on participants\u2019 characteristics, types of interventions, outcomes, synthesising methods and pooled anticipated absolute\/relative effects for outcomes meta-analysed. Two reviewers assessed methodological quality using the A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) tool and assessed the certainty of evidence for prehabilitation using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Overlap among included systematic reviews was quantified using the corrected covered area (CCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty systematic reviews (137 RCTs and 18\u2009941 participants) were included. Low- to moderate-certainty evidence indicated that prehabilitation may improve preoperative physical fitness (eg, 6-minute walk test, preoperative cardiopulmonary function, preoperative lung function), reduce surgical complications and shorten the length of hospital stay. None of the included systematic reviews demonstrated a statistically significant effect on preoperative handgrip strength, 30-day readmission, mortality, anxiety or depression. Findings regarding physical activity and quality of life remained inconsistent. Overlap among included reviews was slight (CCA=4.15%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low- to moderate-certainty evidence suggests that prehabilitation may improve preoperative physical fitness, reduce surgical complications and shorten the length of hospital stay in adult cancer patients undergoing surgery, whereas current evidence does not support a beneficial effect on 30-day readmission, mortality, quality of life or psychological status. Given the predominantly low-to-moderate certainty of the evidence and the methodological heterogeneity across the included systematic reviews, these findings should be interpreted with caution. Methodologically robust and transparently reported RCTs and systematic reviews are needed to strengthen the certainty of evidence and to inform clinical implementation of prehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD 42024533214.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-116006","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:40:29Z","timestamp":1786023629000},"page":"e116006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prehabilitation in adult cancer patients: an overview of systematic reviews"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-3340","authenticated-orcid":false,"given":"Zhao-Yu","family":"Xiong","sequence":"first","affiliation":[{"name":"Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3581-3824","authenticated-orcid":false,"given":"Zhong-Rong","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4358-3774","authenticated-orcid":false,"given":"Ji-Yun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3426-5261","authenticated-orcid":false,"given":"Ting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2463-9576","authenticated-orcid":false,"given":"Sai","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080606401371000_16.8.e116006.1","doi-asserted-by":"crossref","first-page":"e472","DOI":"10.1016\/S1470-2045(23)00412-6","article-title":"Global Cancer Surgery: pragmatic solutions to improve cancer surgery outcomes worldwide","volume":"24","author":"Are","year":"2023","journal-title":"Lancet Oncol"},{"key":"2026080606401371000_16.8.e116006.2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/S1470-2045(20)30675-6","article-title":"Global demand for cancer surgery and an estimate of the optimal surgical and anaesthesia workforce between 2018 and 2040: a population-based modelling study","volume":"22","author":"Perera","year":"2021","journal-title":"Lancet Oncol"},{"key":"2026080606401371000_16.8.e116006.3","first-page":"119","article-title":"The comparison of functional status and health-related parameters in ovarian cancer survivors with healthy controls","volume":"32","author":"Gultekin","year":"2024","journal-title":"Support Care Cancer"},{"key":"2026080606401371000_16.8.e116006.4","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-022-01304-1"},{"key":"2026080606401371000_16.8.e116006.5","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.bja.2021.12.007","article-title":"Prehabilitation, enhanced recovery after surgery, or both? 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