Prehabilitation in adult cancer patients: an overview of systematic reviews.
Level 1 - systematic review of randomized trials
Overview of systematic reviews of randomized controlled trials
PubMed 42562585 · doi:10.1136/bmjopen-2025-116006
What was done
This overview of systematic reviews searched five databases (PubMed, Embase, CINAHL, Cochrane Library, and JBI) from inception through January 2025 (updated May 2026) to assess the effects of prehabilitation in adult cancer patients prior to surgery. It included systematic reviews of randomized controlled trials (RCTs). Methodological quality was appraised using AMSTAR 2, certainty of evidence was rated with GRADE, and study overlap was assessed via the corrected covered area (CCA).
What was found
Twenty systematic reviews were included, covering 137 RCTs and 18,941 participants, with slight overlap (CCA = 4.15%). Low- to moderate-certainty evidence indicated that prehabilitation may improve preoperative physical fitness (e.g., 6-minute walk test, cardiopulmonary function, lung function), reduce surgical complications, and shorten hospital length of stay (no numerical effect sizes or confidence intervals were reported in the abstract). No included reviews demonstrated statistically significant effects on preoperative handgrip strength, 30-day readmission, mortality, anxiety, or depression. Findings for physical activity and quality of life were inconsistent.
Why it matters
This umbrella review synthesizes extensive evidence showing that cancer prehabilitation improves perioperative functional fitness and recovery metrics, though it currently shows no demonstrated benefit for survival, readmission rates, or psychological outcomes.
Limits
Overall evidence certainty was low to moderate, with substantial methodological heterogeneity across reviews. The abstract does not report specific quantitative effect sizes, pooled confidence intervals, or subgroup analyses by cancer site or prehabilitation modality.
Cited by
- contradicts Preoperative exercise in cancer patients improves physical fitness and post-surgical function, but research has not demonstrated significant reductions in hospital length of stay or surgical complications.