Digital Rehabilitation for Gastric Cancer Surgery After Neoadjuvant Therapy

The Effect of Perioperative Rehabilitation Programme Delivered Via a Smart Phone Based Digital Platform in Patients Undergoing Neoadjuvant Therapy for Gastric Cancer Surgery: Study Protocol for a Randomised Controlled Trial

The goal of this clinical trial is to investigate the effects of a perioperative multimodal rehabilitation program on the incidence of postoperative complications and perioperative clinical indexes including functional capacity, nutritional and psychological status in patients with gastric cancer undergoing neoadjuvant therapy. Besides the investigators also develop a smart phone based digital platform aiming to evaluate its effectiveness in improving patient adherence, compared with the conventional telephone supervision approach. The main questions it aims to answer are:

• Can the perioperative multimodal rehabilitation program reduce postoperative complications in patients with gastric cancer undergoing neoadjuvant therapy?
• Can the smart phone based digital platform improve patients' adherence compared to traditional telephone supervision?
• Can the perioperative multimodal rehabilitation program improve the perioperative clinical indicators of patients with gastric cancer undergoing neoadjuvant therapy, including functional capacity, nutritional status and psychological condition? The investigators will compare the perioperative multimodal rehabilitation program with the standard treatment alone to determine whether this program has the effects mentioned above.

Participants will follow the perioperative multimodal rehabilitation program from neoadjuvant therapy through to four weeks after discharge.

Inclusion Criteria:

• patients aged between 18 and 70 years;
• patients with histologically confirmed resectable adenocarcinoma of the oesophago gastric junction or stomach;
• patients referred by a multidisciplinary team (MDT) for neoadjuvant therapy;
• patients able to use a smartphone and the digital follow up platform, and willing to comply with regular follow up assessments;
• patients who provide written informed consent.

Exclusion Criteria:

• presence of distant metastasis;
• severe cardiopulmonary disease or other contraindications precluding completion of the 6MWT or participation in exercise training;
• concurrent other malignant tumours;
• suspected recurrent gastric cancer;
• cognitive impairment, communication barriers, or psychiatric conditions that would prevent compliance with the study procedures;
• women who are pregnant, lactating, or planning a pregnancy.