The feasibility and impact of a pre-surgical exercise intervention program (prehabilitation) for patients undergoing cystectomy for bladder cancer.

OBJECTIVE To assess the feasibility of a prehabilitation program for cystectomy patients and to determine the effectiveness of the program in improving strength and functional capacity in the pen-operative period. MATERIALS AND METHODS This phase III study accrued patients >= 60 years old from January 2013 to October 2017 with biopsy-proven bladder cancer, Karnofsky performance score >= 70 and a sedentary baseline lifestyle to participate in a 4-week supervised preoperative exercise training program. Primary outcomes were feasibility and safety; secondary outcomes included changes in fitness, patient-reported QOL, pen-operative complications and readmissions. Student's ttests and Wilcoxon signed-rank test were performed. RESULTS Fifty-four patients enrolled in the program. Successful completion, defined as patients who began the program and adhered to >70% of the sessions, was attained by 41 of 51 patients (80.4%, 90% CI [71%-90%D. There were no adverse events. Fitness and patient-reported QOL improved postintervention, with sustained improvements in general and mental health 90-days postsurgery. The primary limitation is no control group. CONCLUSION Prehabilitation prior to cystectomy is feasible, safe, and results in improvements in patient strength, endurance and sustained improvements in patient-reported QOL from baseline. Efforts to further evaluate the impact of prehabilitation in this population in an expanded and randomized fashion are warranted. (C) 2020 Elsevier Inc.