Objective:

To evaluate the impact of a trimodal prehabilitation program on anxiety, depression, and health-related quality of life (HRQoL) in patients undergoing colorectal cancer surgery.

Approach:

• Study Design: Single-blind randomized controlled trial involving 45 patients assigned to either trimodal prehabilitation or standard ERAS care.
• Intervention: Trimodal prehabilitation included exercise, nutritional support, and psychological counseling.
• Outcome Measures: Primary outcome was perioperative anxiety measured by GAD-7; secondary outcomes included depressive symptoms (PHQ-9) and HRQoL (SF-36, EORTC QLQ-C30/CR29).

Key Findings:

• GAD-7 scores decreased from 6.2 ± 5.1 to 2.2 ± 3.1 in the intervention group and from 4.7 ± 4.8 to 2.9 ± 2.8 in controls (between-group p < 0.001).
• Perceived health improvement (SF-36 'Health Change') at 52 weeks was 76.6 ± 26.6 in the intervention group vs. 74.8 ± 29.2 in controls (p < 0.00001).
• No significant between-group differences were observed in PHQ-9 scores over time (p = 0.437).
• Significant improvements were observed in emotional functioning and cancer-related fatigue domains of the EORTC QLQ-C30 (p < 0.05).
• Correlations between physical performance and psychological outcomes were not statistically significant.

Interpretation:

Trimodal prehabilitation within an ERAS pathway effectively reduces anxiety and enhances perceived health status in colorectal cancer surgery patients.

Limitations:

• Small sample size limits generalizability.
• Interim analysis may not capture long-term effects.
• Exploratory nature of between-group comparisons.

Conclusion:

Further research is necessary to explore the effects of trimodal prehabilitation on depression and long-term outcomes.

Sources:

• Clinical Trial Registration