# Impact of a hybrid, short-term prehabilitation on patient-reported outcomes in patients undergoing lung resection for non-small cell lung cancer

## TL;DR

A short-term hybrid prehabilitation program improves physical and patient-reported outcomes in lung cancer patients before surgery.

## Contribution

This study demonstrates the effectiveness of a hybrid prehabilitation program in improving outcomes for NSCLC patients.

## Key findings

- Significant improvements in 6-minute walk test and sit-to-stand performance were observed.
- Patient-reported outcomes like EQ-5D-5L and nutritional status improved significantly.
- Females and patients from deprived areas showed greater improvements in outcomes.

## Abstract

We examined the impact of short-term, multimodal prehabilitation on perioperative functional and patient-reported outcomes (PROs) in patients undergoing surgical resection for non-small cell lung cancer (NSCLC).

This is a retrospective study with paired comparisons on consecutive patients worked up for surgical resection for suspected NSCLC referred for prehabilitation including exercise, nutritional, and PROs assessment in a single centre from October 2022 to August 2023. Patients participated in a hybrid programme, with twice-weekly, one-to-one sessions combing high-intensity interval-style and strength training with accompanying app-based exercise and lifestyle support. Functional outcomes were assessed via the 6-minute walk test (6MWT) and 1-minute sit-to-stand (1M-STS), and PROs were evaluated using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) and Patient-Generated Subjective Global Assessment (PG-SGA). A multivariable logistic regression analysis identified factors linked to significant PRO improvement.

During the study period, 85 patients were referred, with 98% consenting and 91% (75/85) completing a median of five sessions over 2.5 weeks, with 69% ultimately undergoing surgical resection. There was significant improvement in 6MWT distance (62.8 m, P < 0.001), 1M-STS (8.9 repetitions < 0.001), EQ-5D-5L (+6 points, P = 0.012) and PG-SGA nutritional status (−0.64 points, P = 0.044). Female sex, lower deprivation index (most deprived) and fewer sessions were associated with greater PRO improvements.

Short-term hybrid prehabilitation for resectable NSCLC improves patient functional and subjective outcomes, particularly among females and those from more deprived areas. This approach appears to enhance preoperative fitness and PROs for patients undergoing surgery potentially reducing postoperative complications and improving postoperative quality of life.

Surgical resection for early-stage non-small cell lung cancer (NSCLC) remains the gold standard in treatment [1, 2].