Past
Surgery is the main curative treatment option for selected patients presenting with cancer. Despite the significant survival benefit, the rates of postoperative morbidity following cancer surgery is high. This results in increased length of hospital stay, decrease in quality of life outcomes, and increase in hospital costs. Prehabilitation aims to provide targeted preoperative interventions, including medical optimization, exercise, nutrition, and psychological support, to improve patient’s health with the intent of reducing postoperative morbidity and enhancing recovery.1 Over the last decade, a number of randomized controlled trials and systematic reviews with meta-analysis have established a promising evidence base knowledge, demonstrating significant reductions on postoperative complications and length of hospital stay,2 however, this field remains relatively infant. Recent studies have identified heterogenicity in reporting and interventions as barriers to establishing high-quality evidence in this growing field.3,4 Therefore, consensus on prehabilitation research priorities could encourage further research in focused areas that are understudied, providing better direction for new investigations.
Present
The Delphi methodology is a validated tool used to gain consensus on a particular topic from a variety of experts. This study employed a Delphi methodology to establish the top research priorities for prehabilitation in cancer surgery. A total of 165 prehabilitation experts, spanning surgeons, anesthesiologists, physiotherapists, dieticians, psychologists, and specialist nurses, were surveyed. Over the course of two rounds of surveys and voting through an online platform, an initial list of 75 research priorities were aggregated to a final list of 10 key research priorities. The top three research priorities included “Effect of prehabilitation on surgical outcomes,” “Optimal composition of prehabilitation programs,” and “Identifying populations most likely to benefit from prehabilitation.” These priorities reflect modern trends in prehabilitation as well as deficits in current literature.5
Anzeige
Future
This international consensus on the top prehabilitation research priorities is vital, as it allows the research community to focus efforts and resources into areas of most benefit. As the evidence base for prehabilitation grows, it may be applied to patients with cancer undergoing surgery more broadly, better preparing patients for surgery and accelerating their recovery. As this field evolves, we propose that a similar Delphi be performed in 5–10 years to focus research efforts on up-to-date priorities.
Acknowledgement
The authors would like to acknowledge the contributions of all prehabilitation experts who participated in our Delphi study.
Disclosure
The authors have no conflicts of interests to disclose. This study did not receive external funding from public or private sectors. There are no grants or sponsorships to disclose.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.