Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study
Open accessAbstract
Background: Recently, the number of prehabilitation trials has increased significantly. The identification of key research priorities is vital in guiding future research directions. Thus, the aim of this collaborative study was to define key research priorities in prehabilitation for patients undergoing cancer surgery. Methods: The Delphi methodology was implemented over three rounds of surveys distributed to prehabilitation experts from across multiple specialties, tumour streams and countries via a secure online platform. In the first round, participants were asked to provide baseline demographics and to identify five top prehabilitation research priorities. In successive rounds, participants were asked to rank research priorities on a 5-point Likert scale. Consensus was considered if > 70% of participants indicated agreement on each research priority. Results: A total of 165 prehabilitation experts participated, including medical doctors, physiotherapists, dieticians, nurses, and academics across four continents. The first round identified 446 research priorities, collated within 75 unique research questions. Over two successive rounds, a list of 10 research priorities reached international consensus of importance. These included the efficacy of prehabilitation on varied postoperative outcomes, benefit to specific patient groups, ideal programme composition, cost efficacy, enhancing compliance and adherence, effect during neoadjuvant therapies, and modes of delivery. Conclusions: This collaborative international study identified the top 10 research priorities in prehabilitation for patients undergoing cancer surgery. The identified priorities inform research strategies, provide future directions for prehabilitation research, support resource allocation and enhance the prehabilitation evidence base in cancer patients undergoing surgery.
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Because prehabilitation is often multicomponent and its components may modify each other's efficacy, pooling heterogeneous interventions limits understanding of which prehabilitation components or combinations are most likely to be efficacious.
“As an often multicomponent intervention where different components (eg, exercise and nutrition) may modify the other’s efficacy,7 19 this limits our ability to understand what prehabilitation components, or combinations of components, are most likely to be efficacious.”
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- Authors
- Raichurkar, P., Denehy, L., Solomon, M., Koh, C., Pillinger, N., Hogan, S., McBride, K., Carey, S., Bartyn, J., Hirst, N., Steffens, D., Collaborative, P. E., Allen, J., Ancog, K., Angenete, E., Ansari, N., Ausania, F., Beaumont, A., Beilstein, C., Berrevoet, F., Boden, I., Bostock, K., Bothe, J., Brandstrup, B., Brennan, L., Brown, K., Burden, S., Burgess, C., Burns, E., Carli, F., Cavalheri, V., Ceelen, W., Chesney, T., Clark, D., Clifford, K., Cole, K., Collyer, T., Copeland, R., Croner, R., Crowe, J., Daniels, I., Danjoux, G., Davis, J., Davis, C., de Klerk, M., Decorte, T., Dekker, J. W., Denys, A., Desender, L., Dries, P., Dunne, D., Edbrooke, L., Edgar, L., Eissa, S., Engel, D., Evans, M., Farrell, R., Finch, A., Fleury, A., Forget, P., Francis, N., Frizelle, F., Frontera, W., Geboes, K., Giddings, H., Gillespie, C., Gillis, C., Glehen, O., Gorey, V., Granger, C., Greenfield, D., Griffiths, B., Grimmett, C., Hackett, C., Hall, T., Hallet, J., Harris, C., Hatcher, S., Hendriks, L., Hermans, M., Ilyas, C., Ismail, H., Jenkins, J., Jiang, W., Johnstone, C., Karakatsanis, A., Karunaratne, S., Kaur, S., Kelly, M., Klaase, J., Kršul, D., Leslie, S., Loeliger, J., Lydrup, M.-L., Maier, A., Major, P., Makker, P., Mantyh, C., McCluskey, S., McGarrity, L., Moloney, J., Montroni, I., Moran, B., Morris, P., Moug, S., Ms, R., Murdoch, S., Myers, A., Ng, K.-S., Nilsson, P. J., Noordzij, P., O’Connor, M., Pellino, G., Philp, S., Pocard, M., Puthucheary, Z., Putrus, E., Quyn, A., Read, T., Ricketts, W., Riedel, B., Rutten, H., Sabajo, C., Salihi, R., Sammour, T., Sandroussi, C., Mina, D. S., Saric, S., Sebio, R., Seyfi, D., Singh, F., Slooter, G., Smart, N., Spencer, L., Sutton, P., Tan, H. E., Cate, D. T., Turna, A., Van Daele, E., van den Berg, A., van Kessel, C., van Ramshorst, G., Verdaasdonk, E., Vu, J., Wakeman, C., West, M., Wheeler, J., Wijeysundera, D., & Yano, H.
- Affiliations
- Royal Prince Alfred Hospital (AU)
- The University of Melbourne (AU)
- The University of Sydney (AU)
- ORCID
- Raichurkar, Pratik
- Denehy, Linda
- Solomon, Michael
- Koh, Cherry
- Pillinger, Neil
- Hogan, Sophie
- McBride, Kate
- Carey, Sharon
- Bartyn, Jenna
- Hirst, Nicholas
- Steffens, Daniel
- Angenete, Eva
- Ansari, Nabila
- Ausania, Fabio
- Beilstein, Christian
- Berrevoet, Frederik
- Boden, Ianthe
- Bostock, Kimberley
- Brandstrup, Birgitte
- Brennan, Louise
- Brown, Kilian
- Burden, Sorrel
- Burns, Elaine
- Carli, Francesco
- Ceelen, Wim
- Chesney, Tyler
- Clark, David
- Clifford, Kari
- Croner, Roland
- Daniels, Ian
- Danjoux, Gerard
- Davis, June
- Decorte, Tina
- Dekker, Jan Willem
- Denys, Andreas
- Desender, Liesbeth
- Dries, Pieter
- Dunne, Declan
- Edbrooke, Lara
- Edgar, Linda
- Engel, Dominique
- Evans, Martyn
- Finch, Alice
- Fleury, Aisling
- Forget, Patrice
- Francis, Nader
- Frizelle, Frank
- Frontera, Walter
- Geboes, Karen
- Giddings, Hugh
- Gillespie, Chris
- Gillis, Chelsia
- Granger, Catherine
- Grimmett, Chloe
- Hackett, Claire
- Hall, Travis
- Hallet, Julie
- Harris, Craig
- Hendriks, Lizza
- Ismail, Hilmy
- Jenkins, John
- Jiang, Wilson
- Johnstone, Charlotte
- Karakatsanis, Andreas
- Karunaratne, Sascha
- Kelly, Michael
- Klaase, Joost
- Kršul, Dorian
- Leslie, Scott
- Loeliger, Jenelle
- Lydrup, Marie-Louise
- Maier, Andrea
- Major, Piotr
- Makker, Preet
- Mantyh, Christopher
- McCluskey, Stuart
- Moloney, Jayson
- Montroni, Isacco
- Moran, Brendan
- Moug, Susan
- Myers, Anna
- Ng, Kheng-Seong
- Nilsson, Per J.
- Noordzij, Peter
- Pellino, Gianluca
- Philp, Shannon
- Pocard, Marc
- Puthucheary, Zudin
- Quyn, Aaron
- Read, Thomas
- Ricketts, William
- Riedel, Bernhard
- Rutten, Harm
- Sabajo, Charissa
- Salihi, Rawand
- Sammour, Tarik
- Sandroussi, Charbel
- Mina, Daniel Santa
- Saric, Stefan
- Sebio, Raquel
- Seyfi, Doruk
- Singh, Favil
- Slooter, Gerrit
- Smart, Neil
- Spencer, Lissa
- Sutton, Paul
- Turna, Akif
- Verdaasdonk, Emiel
- Vu, Jennifer
- West, Malcolm
- Wheeler, James
- Wijeysundera, Duminda
- Yano, Hideaki
- Venue
- Annals of Surgical Oncology
- Published
- 2023-08-24
- Volume
- 30
- Issue
- 12
- Pages
- 7226-7235
- ISSN
- 1068-9265 (ISSN-L)
- 1534-4681
- PMC
- PMC10562336
- OpenAlex
- W4386142387
- Cited by
- 53
- References
- 35
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 21 · 2023: 3
- FWCI
- 14.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Annals of Surgical Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by)
- ePrints Soton (University of Southampton) (acceptedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- SHURA (Sheffield Hallam University Research Archive) (Sheffield Hallam University) (acceptedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
- Griffith Research Online (submittedVersion, cc-by)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
- VU Research Portal (submittedVersion, other-oa)
- Funders
- University of Sydney
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- prehabilitation, cancer surgery, research priorities, postoperative outcomes, neoadjuvant therapy, cost-effectiveness, medication adherence, modes of delivery, expert consensus
- MeSH terms
- Preoperative Exercise, Delphi Technique, Humans, Neoplasms, Physicians, Research Design
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