LB109 - PREHABILITATION IS ASSOCIATED WITH IMPROVED NUTRITIONAL, FUNCTIONAL, AND METABOLIC STATUS BEFORE ELECTIVE COLORECTAL CANCER (CRC) SURGERY

LB109

PREHABILITATION IS ASSOCIATED WITH IMPROVED NUTRITIONAL, FUNCTIONAL, AND METABOLIC STATUS BEFORE ELECTIVE COLORECTAL CANCER (CRC) SURGERY

E. Ferreira^1,1,2,2,*, F. D. S. B. BRITO³, A. SCHTSCHERBYNA¹, E. FIALHO¹

¹Nutrition Institute Josué de Castro, Federal University of Rio de Janeiro, ²Army Central Hospital, ³Nutrition Institute , Rio de Janeiro State University, Rio de Janeiro, Brazil

Rationale: Nutritional, functional, and metabolic impairments are common among patients with CRC and may negatively affect surgical outcomes. This study compared preoperative parameters between patients undergoing prehabilitation and those receiving usual care.

Methods: This prospective cohort study enrolled 79 patients with CRC scheduled for elective surgery. Forty-nine patients participated in a multimodal prehabilitation program, and thirty received usual care. Anthropometric, functional, nutritional, and biochemical parameters were assessed on the day before surgery (T1).

Results: Patients undergoing prehabilitation demonstrated superior nutritional and functional status in the preoperative period, compared with the control group. The prehabilitation group showed a higher prevalence of adequate handgrip strength (89.8% vs. 66.7%; p=0.011), better classification of mid-upper arm muscle circumference (p=0.014), better triceps skinfold adequacy (p=0.036), improved PG-SGA classification (p=0.010), and higher physical activity levels assessed by the IPAQ (p<0.001). Metabolic parameters were also more favorable, including lower fasting blood glucose levels (95.4±10.4 vs. 105.4±21.9 mg/dL; p=0.007), lower prevalence of insulin resistance (36.7% vs. 60.0%; p=0.044), and higher PNI values (49.8±7.8 vs. 45.5±7.0; p=0.017). Additionally, prehabilitation patients exhibited higher serum concentrations of vitamins D (32.4 vs. 22.5 ng/mL; p=0.019) and B12 (458 vs. 348 pg/mL; p=0.029).

Conclusion: Prehabilitation was associated with a superior nutritional, functional, and metabolic profile before surgery in patients with CRC, supporting its role as a strategy to optimize patients before colorectal cancer surgery.

References: Weimann A,  et al. ESPEN Guideline on Clinical Nutrition in Surgery – Update 2025. Clinical Nutrition. 2025.

Disclosure of Interest: None declared