522. can prehabilitation improve health-related quality of life of patients during neoadjuvant chemotherapy for esophagogastric adenocarcinoma?

Abstract Prehabilitation is designed to improve patients’ functional capacity prior to operation in order to better withstand stress of surgery and therefore improve patients’ postoperative outcomes. It is not known whether prehabilitation of patients with esophagogastric adenocarcinoma (EGA) can also improve patients’ centred outcomes. The aim of this study was to assess whether prehabilitation can lead to better health-related quality of life (HRQoL) during neoadjuvant chemotherapy (NAC) treatment for EGA. Patients enrolled into a prospective home-based prehabilitation study (ChemoFit) during NAC for EGA had their HRQoL measured using validated EORTC QLQ-C30 and QLQ-OG25 questionnaires prior NAC and prior to surgery (post-NAC). ChemoFit patients were compared with historical cohort (NO-PREHAB) which did not undergo prehabilitation and which had their HRQoL assessed in the same way during identical time points. Prehabilitation consisted of daily aerobic sessions with step-count target and daily strengthening exercises, under weekly telephone supervision. Mann U Whitney test was used for statistical comparison. There were 31 patients in ChemoFit group and 24 patients in NO-PREHAB cohort. Statistically significant intergroup differences were observed for scores of global quality of life (mean score difference ChemoFit +12.9 vs NO-PREHAB -2.4, p=0.003), physical functioning (+5.8 vs -4.9, p=0.002), role functioning (1.6 vs -13.5, p=0.022) and for symptoms of fatigue (-6.6 vs 9.7, p=0.008) and nausea/vomiting (-10.2 vs 0.7, p=0.030). Patients prehabilitated within ChemoFit study achieved better scores in several HRQoL scales including global quality of life in comparison to historical cohort which did not undergo prehabilitation. These results suggest that prehabilitation of patients with EGA might lead to improvement of their HRQoL prior to operation. It is unknown whether this difference would persist after operation. It is desirable to confirm these findings within randomised controlled trial setting.