Prehabilitation in Geriatric Patients With Colorectal Neoplasia

Results of a Programme of Intensive Prehabilitation in GEriatric Patients Operated for Colo-Rectal Neoplasia

This an interventional, non-pharmacologic study. Prehabilitation is a multidisciplinary preoperative intervention aimed at preventing or reducing functional decline related to surgery and improving perioperative outcomes. The current study is aimed at standardizing a prehabilitation pathway, evaluating its feasibility within the AUSL Romagna in collaboration with the PRIME Centre and the multiple professions that populate the two institutes in the spirit of confirming the beneficial effect of an integrated prehabilitation programme on surgical outcomes.

Patients will follow an intensive prehabilitation course before surgery:

• Colon cancer patients will do 4 weeks of prehabilitation before surgery.
• Rectal cancer patients will do 12 weeks of prehabilitation after neoadjuvant therapy and before surgery.

The prehabilitation course is structured around the following aspects:

• Frailty assessment and identification of optimisation fields
• Optimisation of modifiable factors (anaemia, polypharmacotherapy, smoking, alcoholism, diabetes)
• Assessment by an integrative medicine specialist
• Nutritional pre-qualification
• Cardiovascular, respiratory, motor prehabilitation
• Emotional and psychological prehabilitation

Inclusion Criteria:

1. The participant (or legally acceptable representative if applicable) provides written informed consent for the trial.
2. Male/female participants who are at least 70 years of age on the day of signing informed consent.
3. Patients with confirmed diagnosis of colorectal cancer awaiting major surgery.

Exclusion Criteria:

1. Clinical need for emergency intervention.
2. Severe cognitive impairment (MMSE<20*)
3. Severe dependency (ADL<3)
4. Stage IV colorectal neoplasia