Exercise and nutritional prehabilitation in gastrointestinal cancer patients - prospective controlled trial assessing feasibility, safety and effects on quality of life

Sep 22, 2026

Perioperative morbidity in gastrointestinal cancers is closely linked to diminished physical fitness and compromised nutritional status. Although prehabilitation improves outcomes in colorectal cancer, it is not standard care and has been less studied in other GI malignancies. This prospective controlled trial investigates whether a supervised moderate-to-high intensity exercise program combined with nutritional counseling is feasible, safe, and preliminarily improves health-related quality of life in patients scheduled for GI surgery.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Trial registration

Keywords

Background

Assenbaum etal. BMC Cancer (2026) 26:794 BMC Cancer [https://doi.org/10.1186/s12885-026-16435-y](https://doi.org/10.1186/s12885-026-16435-y) RESEARCH Open Access Exercise and nutritional prehabilitation in gastrointestinal cancer patients: prospective controlled trial assessing feasibility, safety and effects on quality of life Laurie Assenbaum1,2*, Antonia Pahl 1, FreerkT. Baumann2, Cécile Weiß1, Hartmut Bertz1, Gabriel Seifert3, Hannes Neeff3,4 and Christine Greil1 Abstract Background Perioperative morbidity in gastrointestinal (GI) cancers is closely associated with reduced physical fitness and impaired nutritional status. While prehabilitation has been shown to improve outcomes in patients with colorectal cancer (CRC), it is not yet standard of care and remains underexplored in other GI malignancies. This study evaluates the feasibility, safety, and preliminary effectiveness of a supervised moderate-to-high intensity exercise program combined with nutritional counseling in a cohort of GI cancer patients scheduled for surgery. Methods In a prospective, two-arm, controlled trial, patients scheduled for GI cancer surgery were assigned to aprehabilitation program (2–3 sessions/week ≥ 3 weeks, endurance and resistance training with nutritional counseling) or usual care. Primary endpoints were feasibility (eligibility, recruitment, acceptance, retention, adherence) and safety (adverse events) . Secondary endpoint was quality of life (QoL; EORTC QLQ-C30 global score, SF-36 physical and mental health component scores, PCS, MCS), assessed at baseline (t0), presurgery (t1), hospital discharge (t2), and 12-week follow-up (t3) . Results Among the 400 patients assessed for eligibility, 36% met the eligibility criteria. Of those approached, 41% consented to participate, resulting in an overall recruitment rate of 27%(n = 38) . Of the recruited patients, 84% completed the study (n = 32; prehabilitation = 17; usual care = 15; mean age 63.5 years, range 38—85; ICD-10 C15-C26) . Participants attended 95% of the planned sessions (8 .1 ± 3 . 6) within a mean of 30 days (SD ± 16) and completed 59% at the target intensity. Nutritional counseling was provided to 94% of the patients. No intervention-related serious adverse events occurred. A modest improvement in PCS was observed in the prehabilitation group at t1 (+ 4.25 points), although this finding reached statistical significance only in the one-tailed analysis. No between-group differences were observed for global QoL or MCS. Conclusion Multimodal prehabilitation combining supervised moderate-to-high intensity exercise with nutritional counseling is feasible and safe in a real-world GI cancer population. Recruitment and achievement of prescribed *Correspondence: Laurie Assenbaum [laurie.assenbaum@uniklinik-freiburg.de](laurie.assenbaum@uniklinik-freiburg.de) Full list of author information is available at the end of the article © The Author(s) 2026. 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/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Assenbaum et al. BMC Cancer (2026) 26:794 Page 2 of 9 training intensity remain k

FAQs

What does the study evaluate in gastrointestinal cancer patients?

It evaluates the feasibility, safety, and preliminary effectiveness of supervised moderate-to-high intensity exercise combined with nutritional counseling for patients scheduled for GI cancer surgery.

How were participants assigned to the study arms?

Patients were assigned to a prehabilitation program (2–3 sessions/week for at least 3 weeks with endurance and resistance training plus nutritional counseling) or usual care in a prospective two-arm controlled trial.

What were the main feasibility and safety outcomes?

Eligibility screening and recruitment were reported along with adherence to sessions; no intervention-related serious adverse events were observed.

Sep 22, 2026

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