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Background <p>Despite substantial advances in multimodal treatment, esophageal cancer remains associated with a&#xa0;poor prognosis and a&#xa0;high rate of perioperative morbidity. This is particularly evident in older and multimorbid patients, in whom functional impairment, sarcopenia, and malnutrition constitute major risk factors for postoperative complications. In the setting of neoadjuvant treatment, however, a&#xa0;clinically relevant window of opportunity arises for the implementation of prehabilitation strategies aimed at enhancing physiological reserve.</p> Objective <p>The aim of this review is to outline the current role of prehabilitation in patients with esophageal cancer, to analyze its key components, and to critically evaluate the existing evidence regarding its impact on perioperative outcomes and functional recovery.</p> Materials and methods <p>A&#xa0;selective literature search was conducted in the PubMed and Google Scholar databases focusing on prehabilitation strategies in patients with esophageal cancer. The following search terms were used: “prehabilitation,” “esophageal cancer,” “esophageal surgery,” “preoperative exercise,” and “perioperative management.”</p> Conclusion <p>Multimodal prehabilitation shows potential to reduce postoperative complications, improve functional capacity, and enhance recovery following esophagectomy. In particular, structured physical exercise and respiratory rehabilitation demonstrate promising effects. However, implementation in clinical practice is limited by short time intervals, treatment-related side effects, and structural barriers. Further establishment of prehabilitation concepts will require standardized programs and larger randomized controlled trials.</p>

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Prähabilitation beim Ösophaguskarzinom: Evidenz, Strategien und klinischer Stellenwert

  • 期刊论文

  • 发表日期：

    2025年12月19日

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  • Aram Abu Hejleh,
  • Christiane J. Bruns,
  • Thomas Schmidt

摘要

Background

Despite substantial advances in multimodal treatment, esophageal cancer remains associated with a poor prognosis and a high rate of perioperative morbidity. This is particularly evident in older and multimorbid patients, in whom functional impairment, sarcopenia, and malnutrition constitute major risk factors for postoperative complications. In the setting of neoadjuvant treatment, however, a clinically relevant window of opportunity arises for the implementation of prehabilitation strategies aimed at enhancing physiological reserve.

Objective

The aim of this review is to outline the current role of prehabilitation in patients with esophageal cancer, to analyze its key components, and to critically evaluate the existing evidence regarding its impact on perioperative outcomes and functional recovery.

Materials and methods

A selective literature search was conducted in the PubMed and Google Scholar databases focusing on prehabilitation strategies in patients with esophageal cancer. The following search terms were used: “prehabilitation,” “esophageal cancer,” “esophageal surgery,” “preoperative exercise,” and “perioperative management.”

Conclusion

Multimodal prehabilitation shows potential to reduce postoperative complications, improve functional capacity, and enhance recovery following esophagectomy. In particular, structured physical exercise and respiratory rehabilitation demonstrate promising effects. However, implementation in clinical practice is limited by short time intervals, treatment-related side effects, and structural barriers. Further establishment of prehabilitation concepts will require standardized programs and larger randomized controlled trials.