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Objective <p>This systematic review and meta-analysis aimed to establish the effects of exercise-based prehabilitation programs on cardiometabolic health in patients with cancer undergoing surgery.</p> Data source <p>A systematic search was conducted in MEDLINE (via PubMed) and Web of Science from inception to June 2023.</p> Study selection <p>The original systematic search retrieved 16,752 studies. After removal of duplicates and screening by title and abstract, 200 articles were eligible for full-text revision. Finally, a total of nine randomized controlled trials (RCTs), four controlled studies, and six uncontrolled before-and-after studies were included.</p> Outcome measures <p>Changes in blood pressure (systolic and diastolic), lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides levels), glycemic metabolism (fasting glucose, insulin, homeostatic model assessment for insulin resistance, and insulin-growth factor-1), and inflammatory biomarkers (i.e., interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and vascular endothelial growth factor) were assessed.</p> Results <p>The total sample was composed of 651 participants (<i>n</i> = 311 intervention and <i>n</i> = 239 control from RCTs and controlled studies; <i>n</i> = 101 intervention from before-and-after studies), aged 64.90 ± 8.87&#xa0;years (33.76% women). The meta-analyses of uncontrolled before-and-after studies revealed significant prehabilitation-induced reductions in systolic and diastolic blood pressure (<i>d</i> =  − 0.47 and − 0.57, respectively). However, no changes were noted in lipid and glycemic metabolism or inflammatory biomarkers in either controlled or uncontrolled before-and-after studies.</p> Limitations <p>These findings should be interpreted with caution. The small evidence base, inclusion of uncontrolled designs, substantial between-study heterogeneity, and the possibility of publication bias limit the robustness and generalizability of the conclusions.</p> Conclusions <p>Exercise-based prehabilitation programs seems to be effective at reducing blood pressure in patients with cancer undergoing surgery. No effects were noted in other cardiometabolic health outcomes included.</p>

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Impact of exercise-based prehabilitation on cardiometabolic health in surgical patients with cancer: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年9月25日

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  • Manuel Fernandez-Escabias,
  • Javier Jurado,
  • Sofia Carrilho-Candeias,
  • Andrea Orellana-Jaen,
  • Pablo Corres,
  • Andres Marmol-Perez,
  • Carl J. Lavie,
  • Almudena Carneiro-Barrera,
  • Teresa Nestares,
  • Francisco J. Amaro-Gahete

摘要

Objective

This systematic review and meta-analysis aimed to establish the effects of exercise-based prehabilitation programs on cardiometabolic health in patients with cancer undergoing surgery.

Data source

A systematic search was conducted in MEDLINE (via PubMed) and Web of Science from inception to June 2023.

Study selection

The original systematic search retrieved 16,752 studies. After removal of duplicates and screening by title and abstract, 200 articles were eligible for full-text revision. Finally, a total of nine randomized controlled trials (RCTs), four controlled studies, and six uncontrolled before-and-after studies were included.

Outcome measures

Changes in blood pressure (systolic and diastolic), lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides levels), glycemic metabolism (fasting glucose, insulin, homeostatic model assessment for insulin resistance, and insulin-growth factor-1), and inflammatory biomarkers (i.e., interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and vascular endothelial growth factor) were assessed.

Results

The total sample was composed of 651 participants (n = 311 intervention and n = 239 control from RCTs and controlled studies; n = 101 intervention from before-and-after studies), aged 64.90 ± 8.87 years (33.76% women). The meta-analyses of uncontrolled before-and-after studies revealed significant prehabilitation-induced reductions in systolic and diastolic blood pressure (d =  − 0.47 and − 0.57, respectively). However, no changes were noted in lipid and glycemic metabolism or inflammatory biomarkers in either controlled or uncontrolled before-and-after studies.

Limitations

These findings should be interpreted with caution. The small evidence base, inclusion of uncontrolled designs, substantial between-study heterogeneity, and the possibility of publication bias limit the robustness and generalizability of the conclusions.

Conclusions

Exercise-based prehabilitation programs seems to be effective at reducing blood pressure in patients with cancer undergoing surgery. No effects were noted in other cardiometabolic health outcomes included.