{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:38:59Z","timestamp":1790710739543,"version":"4.1.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>\nBackground\n<\/jats:title>\n<jats:p>Emerging research presents divergent perspectives on the efficacy of prehabilitation for patients scheduled for surgery due to upper gastrointestinal (GI) cancers, capturing the attention of both the scientific community and surgical professionals. This quantitative comparative analysis seeks to assess the association of prehabilitation to ameliorate postoperative outcomes in individuals with upper GI cancers, thereby providing a comprehensive evaluation of its potential benefits within a surgical context.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>\nMaterials and methods\n<\/jats:title>\n<jats:p>Medline, Embase, Cochrane Library and Web of Science were searched up to February 2024. Studies reporting the association between prehabilitation, and postoperative complications, readmissions or other outcomes of interest were included. Fixed or random effect models were used, and forest plots were applied to show the results of the quantitative comparative analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>A total of 198 studies were initially screened based on titles and abstracts, with 129 studies subsequently excluded. Overall, 69 full-text studies were identified, of which 12 studies were finally included for qualitative analysis in the quantitative comparative analysis after determining whether the inclusion and exclusion criteria were met. The pooled results indicated that prehabilitation significantly reduced the overall postoperative complication rates in patients with upper GI cancer undergoing surgical therapy with the pooled OR of 0.59 (95%CI: 0.39\u20130.88). Moreover, prehabilitation was also shown to be a protective factor of pulmonary complications (OR: 0.54, 95%CI: 0.36\u20130.80) and ICU readmissions (OR: 0.23, 95%CI: 0.06\u20130.89).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>\nConclusion\n<\/jats:title>\n<jats:p>The correlation between prehabilitation and a reduction in overall postoperative complications, pulmonary complications, and ICU readmissions among patients with upper GI cancer is substantiated by significant data. This pivotal finding necessitates further empirical investigation to validate these initial results and ascertain the clinical efficacy of prehabilitation protocols, thereby informing future surgical practice strategies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315734","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T17:40:01Z","timestamp":1742319601000},"page":"e0315734","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Boosting recovery before surgery: The impact of prehabilitation on upper gastrointestinal cancer patients \u2013 A quantitative comparative analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0409-8846","authenticated-orcid":true,"given":"Yuping","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4090-7793","authenticated-orcid":true,"given":"Liqun","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"pone.0315734.ref001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"pone.0315734.ref002","first-page":"22","article-title":"Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics?","volume":"39","author":"RM Feng","year":"2019","journal-title":"Cancer Commun (Lond)"},{"issue":"23","key":"pone.0315734.ref003","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1056\/NEJMra035010","article-title":"Esophageal cancer","volume":"349","author":"PC Enzinger","year":"2003","journal-title":"N Engl J Med"},{"issue":"10251","key":"pone.0315734.ref004","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0140-6736(20)31288-5","article-title":"Gastric cancer","volume":"396","author":"EC Smyth","year":"2020","journal-title":"Lancet"},{"issue":"6","key":"pone.0315734.ref005","doi-asserted-by":"crossref","first-page":"e2302787","DOI":"10.1002\/adhm.202302787","article-title":"Self-assembled acid-responsive nanosystem for synergistic anti-angiogenic\/photothermal\/ferroptosis therapy against esophageal cancer","volume":"13","author":"X Li","year":"2024","journal-title":"Adv Healthc Mater"},{"issue":"6","key":"pone.0315734.ref006","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1001\/jamasurg.2015.5085","article-title":"Association of frailty and 1-year postoperative mortality following major elective noncardiac surgery: a population-based cohort study","volume":"151","author":"DI McIsaac","year":"2016","journal-title":"JAMA Surg"},{"issue":"1","key":"pone.0315734.ref007","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jcsm.13126","article-title":"The prognostic value of sarcopenia in oesophageal cancer: A systematic review and meta-analysis","volume":"14","author":"P Fang","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"2","key":"pone.0315734.ref008","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1080\/0284186X.2016.1266081","article-title":"Promoting a culture of prehabilitation for the surgical cancer patient","volume":"56","author":"F Carli","year":"2017","journal-title":"Acta Oncol"},{"issue":"7","key":"pone.0315734.ref009","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1007\/s00268-019-04950-y","article-title":"Prehabilitation before major abdominal surgery: a systematic review and meta-analysis","volume":"43","author":"MJ Hughes","year":"2019","journal-title":"World J Surg"},{"key":"pone.0315734.ref010","doi-asserted-by":"crossref","first-page":"105906","DOI":"10.1016\/j.ijsu.2021.105906","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"88","author":"MJ Page","year":"2021","journal-title":"Int J Surg"},{"key":"pone.0315734.ref011","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"D Moher","year":"2009","journal-title":"PLoS Med"},{"key":"pone.0315734.ref012","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"BJ Shea","year":"2017","journal-title":"BMJ"},{"key":"pone.0315734.ref013","doi-asserted-by":"crossref","first-page":"doac046","DOI":"10.1093\/dote\/doac046","article-title":"The effects of prehabilitation on body composition in patients undergoing multimodal therapy for esophageal cancer","volume":"36","author":"L Halliday","year":"2023","journal-title":"Dis Esophagus"},{"issue":"7","key":"pone.0315734.ref014","doi-asserted-by":"crossref","first-page":"doab082","DOI":"10.1093\/dote\/doab082","article-title":"Effect of a multimodal prehabilitation program on postoperative recovery and morbidity in patients undergoing a totally minimally invasive esophagectomy","volume":"35","author":"THJB Janssen","year":"2022","journal-title":"Dis Esophagus"},{"issue":"3","key":"pone.0315734.ref015","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1245\/s10434-021-11002-0","article-title":"Multimodal prehabilitation during neoadjuvant therapy prior to esophagogastric cancer resection: effect on cardiopulmonary exercise test performance, muscle mass and quality of life-a pilot randomized clinical trial","volume":"29","author":"SK Allen","year":"2022","journal-title":"Ann Surg Oncol"},{"issue":"9","key":"pone.0315734.ref016","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1007\/s10147-022-02202-z","article-title":"Preoperative nutrition and exercise intervention in frailty patients with gastric cancer undergoing gastrectomy","volume":"27","author":"Y Wada","year":"2022","journal-title":"Int J Clin Oncol"},{"issue":"11","key":"pone.0315734.ref017","doi-asserted-by":"crossref","first-page":"2733","DOI":"10.1007\/s11605-020-04881-3","article-title":"The impact of prehabilitation on post-operative outcomes in oesophageal cancer surgery: a propensity score matched comparison","volume":"25","author":"LJ Halliday","year":"2021","journal-title":"J Gastrointest Surg"},{"issue":"1","key":"pone.0315734.ref018","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/s10388-020-00757-2","article-title":"Efficacy of enhanced prehabilitation for patients with esophageal cancer undergoing esophagectomy","volume":"18","author":"Y Akiyama","year":"2021","journal-title":"Esophagus"},{"issue":"1","key":"pone.0315734.ref019","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1002\/bjs5.50110","article-title":"Safety and feasibility of preoperative exercise training during neoadjuvant treatment before surgery for adenocarcinoma of the gastro-oesophageal junction","volume":"3","author":"JF Christensen","year":"2018","journal-title":"BJS Open"},{"issue":"12","key":"pone.0315734.ref020","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1001\/jamasurg.2018.1645","article-title":"Effect of exercise and nutrition prehabilitation on functional capacity in esophagogastric cancer surgery: a randomized clinical trial","volume":"153","author":"EM Minnella","year":"2018","journal-title":"JAMA Surg"},{"issue":"12","key":"pone.0315734.ref021","doi-asserted-by":"crossref","first-page":"3733","DOI":"10.1007\/s00520-017-3801-x","article-title":"Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy","volume":"25","author":"Y Akiyama","year":"2017","journal-title":"Support Care Cancer"},{"issue":"5","key":"pone.0315734.ref022","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s10120-016-0683-4","article-title":"Effectiveness of a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer","volume":"20","author":"K Yamamoto","year":"2017","journal-title":"Gastric Cancer"},{"issue":"6","key":"pone.0315734.ref023","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1245\/s10434-013-3394-7","article-title":"Matched pair analysis to examine the effects of a planned preoperative exercise program in early gastric cancer patients with metabolic syndrome to reduce operative risk: the Adjuvant Exercise for General Elective Surgery (AEGES) study group","volume":"21","author":"H Cho","year":"2014","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"pone.0315734.ref024","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1002\/pri.1524","article-title":"Feasibility and effectiveness of pre-operative inspiratory muscle training in patients undergoing oesophagectomy: a pilot study","volume":"18","author":"DS Dettling","year":"2013","journal-title":"Physiother Res Int"},{"issue":"4","key":"pone.0315734.ref025","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.bpa.2021.01.001","article-title":"Prehabilitation before surgery: is it for all patients?","volume":"35","author":"MA West","year":"2021","journal-title":"Best Pract Res Clin Anaesthesiol"},{"issue":"1","key":"pone.0315734.ref026","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/SLA.0000000000004527","article-title":"The impact of prehabilitation on patient outcomes in hepatobiliary, colorectal, and upper gastrointestinal cancer surgery: a PRISMA-accordant meta-analysis","volume":"274","author":"JE Lambert","year":"2021","journal-title":"Ann Surg"},{"issue":"1","key":"pone.0315734.ref027","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/s13643-018-0771-0","article-title":"Preoperative exercise therapy for gastrointestinal cancer patients: a systematic review","volume":"7","author":"SA Vermillion","year":"2018","journal-title":"Syst Rev"},{"issue":"4","key":"pone.0315734.ref028","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1007\/s40140-017-0245-2","article-title":"Prehabilitation and nutritional support to improve perioperative outcomes","volume":"7","author":"MA West","year":"2017","journal-title":"Curr Anesthesiol Rep"},{"issue":"Suppl 5","key":"pone.0315734.ref029","doi-asserted-by":"crossref","first-page":"S632","DOI":"10.21037\/jtd.2019.02.12","article-title":"Prehabilitation for esophagectomy","volume":"11","author":"E Doganay","year":"2019","journal-title":"J Thorac Dis"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T17:40:12Z","timestamp":1742319612000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315734"}},"subtitle":[],"editor":[{"given":"Mert","family":"Tanal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0315734","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]}}}