Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Multimodal Prehabilitation For Upper Gastrointestinal Cancer Surgery Patients at Sir Charles Gairdner Osborne Park Health Care Group: Standardisation Of Pathways, Assessment Of Feasibility And Evaluation Of Service (117321)

Yang Jian Ong 1 , Jonathan Foo 2 , Jing Xiao 3 , Deepankar Majumdar 3 , Chanelle Curnuck 4 , Emma Whelan 4 , Luisa Perrella 5 , Maryanne Lanigan 2 , Heather Lane 1
  1. Geriatric, Acute and Rehabilitation Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
  2. Upper GI and General Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
  3. Anaesthesia Department, Sir Charles Gairdner Hospital, Nedlands, WA , Australia
  4. Dietetics and Nutrition, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
  5. Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

Aim

Multimodal Prehabilitation Upper Gastrointestinal (UGI) Cancer Surgery Guideline (UGI Prehab Guide) was developed to streamline prehabilitation referrals for UGI cancer patients undergoing cancer surgery. The primary aim was to examine prehabilitation service referral rates using UGI Prehab Guide. The secondary aim was to examine patient demographics and postoperative outcome after UGI Prehab Guide implementation.

 

Methods

UGI surgical cancer patients attending UGI Cancer Surgical Clinic from 01 August 2023 to 31 December 2023 (pre-Guide cohort) were referred to prehabilitation service based on surgical team discretion whereas patients from 01 January 2024 to 31 May 2024 (Guide cohort) were referred using UGI Prehab Guide. Data on patient demographics, postoperative complication rates, 30-day hospital readmission rates, hospital and ICU length of stay were collected.

 

Results 

20 patients were identified in pre-Guide cohort with median age 71 years (IQR 60.0–74.0) and 15 patients in Guide cohort with median age 69 years (IQR 62.5–73.0). At least 50% of both patient cohorts had AJCC Stage II UGI cancer, modified Charlson Comorbidity Index ≥2 and moderate to high malnutrition risk[1,2]. There were no statistical differences between cohorts in prehabilitation referral rates, postoperative complication rates, 30-day hospital readmission rates, hospital and ICU length of stay. 

 

Conclusion

Our study did not show prehabiltation referral rate changes using UGI Prehab Guide but it was evident that UGI cancer patients in our study were comorbid patients with malnutrition risk. Routine referrals to prehabilitation service as standard practice in this patient cohort could be considered given high risk cancer surgery. 

 

  1. 1. Amin MB, Greene FL, Edge SB, et al. (2017). American Joint Committee on Cancer. AJCC Cancer Staging Manual Eighth Edition. Chicago: Springer Cham.
  2. 2. Marventano S, Grosso G, Mistretta A, et al. Evaluation of four comorbidity indices and Charlson comorbidity index adjustment for colorectal cancer patients. Int J Colorectal Dis. 2014;29(9)1159-69.