ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
This article is part of the Research TopicThe Role of Nutrition in Enhancing Surgical Recovery and OutcomesView all 10 articles
Multimodal Prehabilitation Enhances Perioperative Outcomes in Gastric Cancer Patients: A Single-Center Randomized Controlled Trial
Provisionally accepted
- Guangxi Medical University, Nanning, China
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Introduction: Multimodal prehabilitation, integrating exercise, nutrition, and psychological support, has shown value in perioperative care for gastrointestinal cancers, but its efficacy—especially as a short-course intervention tailored to gastric cancer's need for timely surgery—remains insufficiently validated. Methods: Eligible patients undergoing radical gastrectomy received either a 1-week multimodal prehabilitation program plus standard perioperative care (prehabilitation group) or standard perioperative care alone (control group). Primary endpoint was the 30-day postoperative complication rate; secondary endpoints included functional capacity, patient-reported outcomes, recovery metrics, and hospital stay. Results: Recruitment was conducted from July 2022 to July 2024. A total of 150 patients were randomized, with 131 completing the trial (66 in the prehabilitation group, 65 in the control group). Baseline demographics (gender, age, education level) and clinical characteristics (comorbidities, TNM staging, surgical details) were comparable between groups (all P > 0.05). For the primary endpoint, the prehabilitation group had a significantly lower 30-day overall complication rate (9.1% vs 26.2%, P = 0.010), with the largest reduction in pulmonary infections (6.1% vs 21.5%, P < 0.05). For secondary endpoints, the prehabilitation group showed earlier time to first flatus (58.32 ± 26.82 vs 89.55 ± 26.14 hours, P < 0.001), shorter interval to oral intake (48.43 ± 31.98 vs 105.85 ± 57.36 hours, P < 0.001), reduced time to ambulation (25.14 ± 10.63 vs 38.99 ± 21.01 hours, P < 0.001), and shorter postoperative hospital stay (7.76 ± 1.57 vs 9.77 ± 3.80 days, P < 0.001). They also had superior preoperative 6MWD (448.60 ± 103.65 vs 362.43 ± 91.85 m, P < 0.001), higher preoperative caloric (25.21 ± 6.33 vs 16.34 ± 4.44 Kcal/kg IBW, P < 0.001) and protein intake (1.24 ± 0.35 vs 0.62 ± 0.25 g/kg IBW, P < 0.001), higher discharge QoR-40c scores (P < 0.05), and lower Hospital Anxiety and Depression Scale (anxiety: P = 0.026, depression: P < 0.001) and Fatigue Severity Scale scores (P = 0.003). Conclusion: Multimodal prehabilitation (integrating exercise, nutrition, and psychological support) significantly improves perioperative outcomes in gastric cancer patients—including reducing postoperative complications, accelerating functional recovery, and enhancing psychological well-being.
Keywords: multimodal prehabilitation, gastric cancer, Perioperative outcomes, functional capacity, Quality of Life
Received: 30 Jul 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Mu, Tu, Xie, Liu, Jia, He, Chen and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Junqiang Chen
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