Unimodal to Multimodal Prehabilitation in Gastric Cancer Surgery: Systematic Review of Randomised Controlled Trials

作者：Wobith M, Guinan E, Cheong E, Mockler D, O'Neill L · 发表于：Journal of gastrointestinal cancer · 年份：2026 · DOI：10.1007/s12029-026-01519-6 · 研究领域：Gastrectomy、Gastric cancer、Outcomes、Perioperative care、Prehabilitation

PURPOSE: Prehabilitation prior to gastric cancer resection aims to optimise pre-operative physical and nutritional status to improve perioperative resilience. However, the current evidence-base is fragmented. This review synthesized randomized controlled trial (RCT) evidence evaluating effectiveness of prehabilitation interventions prior to gastric cancer resection and characterized reported outcomes. METHODS: A systematic review was conducted following PRISMA guidelines (PROSPERO registration -CRD420251233981). MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL were searched up to August 2025. Eligible studies were RCTs investigating unimodal or multimodal prehabilitation interventions (minimum duration 7 days) prior to gastric cancer resection. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Heterogeneity precluded meta-analysis and results were synthesized narratively. RESULTS: Fourteen RCTs were included: four multimodal, and ten unimodal interventions (nutritional (n = 9), spirometry (n = 1)), duration range (7-days to 15-weeks). Fifty-three unique outcomes were reported across five domains: clinician/observer-reported outcomes, performance outcomes, patient-reported outcomes, biomarkers, and non-health outcomes. Multimodal prehabilitation programs suggest potential benefits; fewer postoperative complications, and improved functional capacity. Short-duration unimodal nutritional interventions demonstrated mixed eff...