Benefits of prehabilitative exercise on physiological, functional and patient-reported outcomes in patients undergoing oncologic surgery: A systematic review and meta-analysis
In brief
Pre-surgery exercise raises fitness and function by roughly one-third SD
A meta-analysis of 27 randomized trials (2,005 cancer patients) found that structured pre-operative exercise increased cardiorespiratory fitness (effect size ≈0.3), physical function (≈0.36) and quality of life (≈0.2), while reducing fatigue before surgery. Benefits persisted after operation, suggesting that integrating exercise into oncologic pathways can blunt peri-operative decline, though evidence certainty varies.
- Journal
- Journal of cancer survivorship : research and practice (Q1)
- Published
- 29 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Natália Casagrande, Favil Singh, Anderson Rech, Régis Radaelli, Bruna M Paniz, Guilherme T Silvestro, et al.
- PMID
- 42667547
- DOI
- 10.1007/s11764-026-02107-0
Why clinicians should know about it
- Picked for Surgery (top studies of the week, 30 August 2026): Prehabilitation improves fitness, function, QoL in oncologic surgery
Abstract
PURPOSE: Prehabilitation, delivered between cancer diagnosis and surgery, may enhance functional reserve and improve tolerance to surgical stress, but evidence remains conflicting across cancer types and outcomes. We aimed to evaluate the effects of prehabilitative exercise on physiological, functional, and patient-reported outcomes in patients undergoing oncologic surgery. METHODS: A systematic review and meta-analysis was conducted (PROSPERO: CRD420251072796). Randomized controlled trials comparing structured exercise interventions with usual care in adults undergoing oncologic surgery were included. Searches were performed across seven databases until June 2025. Outcomes included cardiorespiratory fitness, muscle strength, physical function, fatigue, psychological distress, and quality of life. A three-level mixed-effects meta-analysis evaluated intervention effects and moderators. RESULTS: Twenty-seven studies (n = 2005) were included. Prehabilitation significantly improved cardiorespiratory fitness (SMD 0.31, p = 0.010), physical function (SMD 0.36, p < 0.001), and quality of life (SMD 0.19, p = 0.030), with sustained postoperative benefits in physical function. Fatigue was reduced preoperatively (SMD -0.21, p = 0.017), while muscle strength and psychological distress were preserved relative to baseline. Certainty of evidence ranged from very low to moderate. CONCLUSIONS: Prehabilitative exercise improves preoperative fitness, function, fatigue, and quality of life, and attenuates perioperative decline in patients undergoing cancer surgery. These findings support integrating structured exercise into perioperative oncology pathways to optimise recovery and long-term outcomes. IMPLICATIONS FOR CANCER SURVIVORS: Prehabilitative exercise may mitigate perioperative deconditioning and facilitates a return to baseline function. By potentially preserving functional reserve against surgical stress, these interventions could contribute to improved long-term survivorship trajectories and should be considered within structured, individualised perioperative care pathways.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.