Shao X, Zhu YY, Shang B, Cai FJ, Wang XY, Zhou K, Luo CF. Meta-analysis of the impact of prehabilitation on patients undergoing upper gastrointestinal tract tumor surgery. World J Clin Oncol 2025; 16(9): 110130 [PMID: 41024846 DOI: 10.5306/wjco.v16.i9.110130]
Corresponding Author of This Article
Cai-Feng Luo, MD, PhD, School of Medicine, Jiangsu University, No. 3 Yizheng Road, Zhenjiang 212000, Jiangsu Province, China. lcf01051@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Sep 24, 2025; 16(9): 110130 Published online Sep 24, 2025. doi: 10.5306/wjco.v16.i9.110130
Meta-analysis of the impact of prehabilitation on patients undergoing upper gastrointestinal tract tumor surgery
Xiao Shao, Yan-Yan Zhu, Bin Shang, Feng-Juan Cai, Xiao-Yan Wang, Kun Zhou, Cai-Feng Luo
Xiao Shao, Bin Shang, Cai-Feng Luo, School of Medicine, Jiangsu University, Zhenjiang 212000, Jiangsu Province, China
Xiao Shao, Feng-Juan Cai, Endoscopy Center, Jiangsu Province (Suqian) Hospital, Suqian 223800, Jiangsu Province, China
Yan-Yan Zhu, Department of Cerebral Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang 212008, Jiangsu Province, China
Xiao-Yan Wang, Department of Digestive, Jiangsu Province (Suqian) Hospital, Suqian 223800, Jiangsu Province, China
Kun Zhou, Department of Oncology, Nanjing Drum Tower Hospital Group Suqian Hospital, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu Province, China
Co-first authors: Xiao Shao and Yan-Yan Zhu.
Author contributions: Shao X, Zhu YY, and Luo CF conceptualized and designed the research study, and drafted the initial manuscript; Shao X and Zhu YY contributed equally to this article, and are co-first authors of this manuscript; Shang B and Cai FJ contributed to data acquisition; Wang XY and Zhou K conducted data analysis and carried out visual processing; and all authors have contributed to the article, reviewed the final manuscript, and collectively take responsibility for all aspects of the research.
Supported by Key Project of Jiangsu Provincial Health (ZD2022052).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: May 30, 2025 Revised: June 24, 2025 Accepted: August 25, 2025 Published online: September 24, 2025 Processing time: 117 Days and 0.1 Hours
Abstract
BACKGROUND
Upper gastrointestinal cancer (UGIC), including esophageal and gastric cancers, poses a major global health challenge due to its high morbidity and mortality. During the preoperative period, patients often face functional decline, malnutrition, and psychological stress, which can impair recovery. Prehabilitation, a multidisciplinary preoperative intervention, shows promise in optimizing patients' physical and mental status.
AIM
To evaluate the impact of prehabilitation on patients undergoing UGIC surgery and provide a basis for implementation of the prehabilitation compound plan.
METHODS
A computerized search of databases including Web of Science, PubMed, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, Wanfang, and Chinese Science and Technology Journal Database was used to collect clinical trials on the impact of prehabilitation on patients undergoing UGIC surgery. After screening, a meta-analysis was conducted using Review Manager 5.0 software, and linear regression analysis was performed on the prehabilitation duration and outcome indicators.
RESULTS
A total of 13 clinical trials were ultimately included, with 8 literature quality evaluations at A level and 5 literature quality evaluations at B level. The meta-analysis results showed that compared with conventional nursing, the prehabilitation group had higher six-minute walk distance, lower postoperative complications and mortality rates, and shorter hospital stays, with statistically significant differences; there were no statistically significant differences in intensive care unit monitoring time and albumin levels between the two groups; regression analysis between prehabilitation duration and outcome indicators showed no significant relationship.
CONCLUSION
Prehabilitation can improve the perioperative functional ability of patients with UGIC and promote postoperative recovery, but its impact on nutrition, psychology, and quality of life needs to be further explored through more high-quality trials; in addition, further research is needed on the prehabilitation time, location, and specific plan.
Core Tip: This meta-analysis evaluates the impact of prehabilitation-a multidisciplinary intervention including exercise, nutrition, and psychological support-on patients undergoing upper gastrointestinal cancer surgery. Prehabilitation significantly improved functional status, reduced postoperative complications and mortality, and shortened hospital stays. No significant improvement was observed in nutritional indicators or intensive care unit stay. These findings support integrating prehabilitation into perioperative care for upper gastrointestinal cancer, although further high-quality trials are warranted to refine protocols and assess psychological and nutritional outcomes.
