Reduce the length of hospital stay
Two meta-analyses of studies of aerobic exercise programmes in lung cancer patients reported shorter hospital stays in the exercise groups (4-5). A prospective, non-randomised controlled clinical trial of physical activity prior to radical prostatectomy (6) and a systematic review of physical prehabilitation in surgery for colorectal cancer (2) however found no significant difference in hospital stay. The quality of studies in older patients undergoing colorectal surgery is poor.
Quality of evidence
Strength of recommendation
Weak – on the basis of existing evidence and expert clinical opinion, some cancer patients may be expected to have improvements in length of hospital stay with pre-surgical physical activity.
Meta-analyses of studies in lung cancer have reported promising results with length of hospital stay post-surgery, however there is a need for further high-quality studies for all cancer groups.
Singh F et al. A systematic review of pre-surgical exercise intervention studies with cancer patients. Surg Oncol.2013 Jun;22(2):92-104
Bruns ER et al. The effects of physical prehabilitation in elderly patients undergoing colorectal surgery: a systematic review. Colorectal Dis.2016 Aug;18(8):O267
Hijazi Y et al. A systematic review of prehabilitation programs in abdominal cancer surgery. Int J Surg.2017 Mar;39:156-162
Cavalheri V et al. Preoperative exercise training for patients with non-small cell lung cancer. Cochrane Database Syst Rev.2017 Jun 7;6:CD012020
Garcia R et al. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg.2016 Sep;23(3):486-97
Angenete E et al. Physical activity before radical prostatectomy reduces sick leave after surgery – results from a prospective, non-randomized controlled clinical trial (LAPPRO). BMC Urol. 2016; 16: 50
Cho H et al. Matched pair analysis to examine the effects of a planned preoperative exercise program in early gastric cancer patients with metabolic syndrome to reduce operative risk: the Adjuvant Exercise for General Elective Surgery (AEGES) study group. Ann Surg Oncol. 2014 21(6):2044-50