{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T10:36:12Z","timestamp":1793529372419,"version":"4.5.0"},"reference-count":58,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Sydney Postgraduate Award"},{"name":"Cancer Institute NSW Career Development Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and\/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and\/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and\/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59\u20132.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40\u20138.84; four trials), depression (MD = 2.82; 95% CI: 0.65\u20134.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97\u201313.23; three trials) and distress (MD = 1.23; 95% CI: 0.30\u20132.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies.<\/jats:p>","DOI":"10.3390\/cancers18020296","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T09:57:02Z","timestamp":1768816622000},"page":"296","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Technology-Enabled (P)rehabilitation for Patients Undergoing Cancer Surgery: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5255-649X","authenticated-orcid":false,"given":"Tiffany R.","family":"Tsoukalas","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zirong","family":"Bai","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8355-8348","authenticated-orcid":false,"given":"Claire","family":"Jeon","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Huynh","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Gu","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7163-097X","authenticated-orcid":false,"given":"Kate","family":"Alexander","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula R.","family":"Beckenkamp","sequence":"additional","affiliation":[{"name":"Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4779-6324","authenticated-orcid":false,"given":"Adrian","family":"Boscolo","sequence":"additional","affiliation":[{"name":"Sydney Local Health District, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kilian","family":"Brown","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"},{"name":"Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia"},{"name":"Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW 2050, 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Australia"},{"name":"Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Chen","sequence":"additional","affiliation":[{"name":"The Data Science Institute, University of Technology Sydney, Sydney, NSW 2007, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Cummins","sequence":"additional","affiliation":[{"name":"NeuroEndocrine Cancer Australia, Blairgowrie, VIC 3942, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4039-5169","authenticated-orcid":false,"given":"Haryana M.","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW 2050, 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of Sydney, Sydney, NSW 2050, Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Keck","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, St Vincent\u2019s Private Hospital, Fitzroy, VIC 3065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bora","family":"Kim","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, The University of Sydney and Cancer Council NSW, Sydney, NSW 2011, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherry","family":"Koh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, 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Parkville, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8164-8786","authenticated-orcid":false,"given":"Angus","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Health Informatics Unit, Sydney Local Health District, Camperdown, NSW 2050, Australia"},{"name":"Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charbel","family":"Sandroussi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia"},{"name":"Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, 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