{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:12:45Z","timestamp":1773839565277,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.55324.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000}}],"reference-count":61,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NHS England"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Surgical resection remains the primary curative treatment for intra-cavity cancer. Low physical fitness and psychological factors such as depression are predictive of post\u2013operative morbidity, mortality and length of hospital stay. Prolonged post-operative morbidity is associated with persistently elevated risk of premature death. We aim to investigate whether a structured, responsive exercise training programme, a psychological support programme or combined exercise and psychological support, delivered between treatment decision and major intra-cavity surgery for cancer, can reduce length of hospital stay, compared with standard care.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    WesFit is a pragmatic\n                    <ns4:bold>,<\/ns4:bold>\n                    2x2 factorial-design, multi-centre, randomised-controlled trial, with planned recruitment of N=1560. Participants will be randomised to one of four groups. Group 1 (control) will receive usual pre-operative care, Group 2 (exercise) patients will undergo 2\/3 aerobic, high-intensity interval training sessions per week supervised by personal trainers. Group 3 (psychological support) patients are offered 1 session per week at a local cancer support centre. Group 4 will receive both exercise and psychological support. All patients undergo baseline and pre-operative cardiopulmonary exercise testing, complete self-report questionnaires and will be followed up at 30 days, 12 weeks and 12 months post-operatively. Primary outcome is post-operative length-of-stay. Secondary outcomes include disability-adjusted survival at 1-year postoperatively, post-operative morbidity, and health-related quality of life. Exploratory investigations include objectively measured changes in physical fitness assessed by cardiopulmonary exercise test, disease-free and overall mortality at 1-year postoperatively, longer-term physical activity behaviour change, pre-operative radiological tumour regression, pathological tumour regression, pre and post-operative body composition analysis, health economics analysis and nutritional characterisation and its relationship to post-operative outcome.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    The WesFit trial will be a randomised controlled study investigating whether a high-intensity exercise training programme +\/- psychological intervention results in improvements in clinical and patient reported outcomes in patients undergoing major inter-cavity resection of cancer.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>ClinicalTrials.gov registration:<\/ns4:bold>\n                    NCT03509428 (26\/04\/2018)\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.55324.2","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T06:58:00Z","timestamp":1659423480000},"page":"952","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["The Wessex Fit-4-Cancer Surgery Trial (WesFit): a protocol for a factorial-design, pragmatic randomised-controlled trial investigating the effects of a multi-modal prehabilitation programme in patients undergoing elective major intra\u2013cavity cancer 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Clinical Trial.","author":"A Onerup","year":"2021","journal-title":"Ann Surg."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"36-42","DOI":"10.1111\/anae.14507","article-title":"Psychological factors, prehabilitation and surgical outcomes: evidence and future directions.","volume":"74","author":"D Levett","year":"2019","journal-title":"Anaesthesia."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"919-28","DOI":"10.1016\/j.jclinepi.2006.12.003","article-title":"The Postoperative Morbidity Survey was validated and used to describe morbidity after major surgery.","volume":"60","author":"M Grocott","year":"2007 Sep","journal-title":"J Clin Epidemiol."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"205-13","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey.","volume":"240","author":"D CLavien Dindo Dindo","year":"2004","journal-title":"Ann Surg."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1-7","DOI":"10.1097\/SLA.0b013e318296c732","article-title":"The comprehensive complication index: a novel continuous scale to measure surgical morbidity.","volume":"258","author":"K Slankamenac","year":"2013 Jul","journal-title":"Ann Surg."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1727-36","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L).","volume":"20","author":"M Herdman","year":"2011","journal-title":"Qual Life Res."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"365-76","DOI":"10.1093\/jnci\/85.5.365","article-title":"The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in Oncology.","volume":"85","author":"N Aaronson","year":"1993","journal-title":"J Natl Cancer Inst."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"484-500","DOI":"10.1016\/j.bja.2017.10.020","article-title":"Perioperative cardiopulmonary exercise testing (CPET): consensus clinical guidelines on indications, organization, conduct, and physiological interpretation.","volume":"120","author":"D Levett","year":"2018","journal-title":"Br J Anaesth."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1134-42","DOI":"10.1016\/j.pec.2020.01.001","article-title":"Use of healthy conversation skills to promote healthy diets, physical activity and gestational weight gain: Results from a pilot randomised controlled trial.","volume":"103","author":"L Adam","year":"2020 Jun","journal-title":"Patient Educ Couns."},{"key":"ref52","first-page":"85-8","article-title":"Self-efficacy determinants and consequences of physical activity.","volume":"28","author":"E McAuley","year":"2000 Apr","journal-title":"Exerc Sport Sci Rev."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"81-95","DOI":"10.1007\/s12160-013-9486-6","article-title":"The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions.","volume":"46","author":"S Michie","year":"2013","journal-title":"Ann Behav Med."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"997-1006","DOI":"10.1139\/H08-075","article-title":"A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care.","volume":"33","author":"M Mourtzakis","year":"2008","journal-title":"Appl Physiol Nutr Metab."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"1539-47","DOI":"10.1200\/JCO.2012.45.2722","article-title":"Cancer cachexia in the age of obesity: Skeletal muscle depletion is a powerful prognostic factor, independent of body mass index.","volume":"31","author":"L Martin","year":"2013","journal-title":"J Clin Oncol."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"228-47","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1).","volume":"45","author":"E Eisenhauer","year":"2009","journal-title":"Eur J Cancer."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"5-21","DOI":"10.1093\/bmb\/ldq033","article-title":"Health outcomes in economic evaluation: The QALY and utilities.","volume":"96","author":"S Whitehead","year":"2010","journal-title":"Br Med Bull."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"908-12","DOI":"10.1038\/sj.bjc.6604952","article-title":"Hospital anxiety and depression scale cutoff scores for cancer patients in acute care.","volume":"100","author":"S Singer","year":"2009 Mar","journal-title":"Br J Cancer."},{"key":"ref59","first-page":"256-62","article-title":"Effect of a self-management program on patients with chronic disease.","volume":"4","author":"K Lorig","year":"2001","journal-title":"Eff Clin Pract."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1918-30","DOI":"10.1111\/j.1475-6773.2005.00438.x","article-title":"Development and testing of a short form of the patient activation measure.","volume":"40","author":"J Hibbard","year":"2005 Dec","journal-title":"Health Serv Res."},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-63","article-title":"Normalisation process theory: A framework for developing, evaluating and implementing complex interventions.","volume":"8","author":"E Murray","year":"2010","journal-title":"BMC Med."},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.5258\/SOTON\/D1790","article-title":"The Wessex Fit-4-Cancer Surgery Trial (WesFit): a protocol for a factorial-design, pragmatic randomised-controlled trial investigating the effects of a multi-modal prehabilitation programme in 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