Family-Supervised Prehabilitation to Reduce Postoperative Complications After Neoadjuvant Chemotherapy in Gastric Cancer

Effect of Family-Supervised Multimodal Prehabilitation Throughout Preoperative Neoadjuvant Chemotherapy on Clinical Outcomes in Gastric Cancer Patients: A Single-Center Randomized Controlled Trial

This study evaluates whether a family-supervised exercise-nutrition-psychology program can reduce complications after stomach-cancer surgery. Eligible patients are adults who will receive chemotherapy before surgery. Participants are randomly assigned to either the multimodal prehabilitation program plus usual care or usual care alone. The main outcome is the rate of serious complications within 30 days after surgery. Potential benefits include fewer complications and faster recovery; risks are minimal and mainly related to mild exercise fatigue.

Inclusion Criteria:

• Age 18-80 years
• Histologically proven gastric adenocarcinoma by gastroscopy
• Clinical stage T2-4a, N any, M0 planned for neoadjuvant chemotherapy plus radical gastrectomy
• ECOG performance status 0-1; ASA class I-III
• Able to understand the study and provide signed informed consent

Exclusion Criteria:

• Previous or concurrent malignancies
• Emergent conditions (bleeding, perforation, obstruction) requiring immediate surgery
• Pregnant or lactating women
• Severe psychiatric disorders
• Prior major abdominal surgery (except laparoscopic cholecystectomy)
• Unstable angina, myocardial infarction, or cerebrovascular event within 6 months
• Continuous use of NSAIDs, corticosteroids, or probiotics within 1 month
• Simultaneous surgery for other diseases
• FEV1 < 50 % predicted
• Any condition that, in the investigator's opinion, contraindicates participation