Clinical Trial Comparing Standard Care Versus Prehabilitation in Patients Undergoing Cancer Surgery

NCT ID: NCT04880772

Last Updated: 2023-09-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-15

Study Completion Date

2023-07-13

Brief Summary

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To determine whether exercise and nutrition prehabilitation improves patient outcomes after cancer surgery

Detailed Description

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Preliminary qualitative and quantitative studies suggest that there are benefits (reduced length of stay, improved cardiorespiratory function, reduced postoperative complications and improved quality of life) when prehabilitation is used with the context of cancer care. In 2017 Macmillian Cancer Support developed a strategic 'Evidence and Insight' review on prehabilitation. The outcome of this was to incorporate prehabilitation into routine cancer care and to develop principles and guidance for prehabilitation. This study aims to support this vision and answer some of the questions on the patients who are most likely to benefit from prehabilitation and to quantify some of these benefits by investigating the molecular processes that influence clinical changes

This study primarily seeks to assess the cardiovascular and biological impact of prehabilitation (exercise, nutrition) on patients undergoing hepatobiliary and colorectal cancer surgery. The investigators aim to assess whether there is an improvement in various cardiopulmonary exercise testing (CPET) variables such as maximum oxygen consumption and anaerobic threshold. The investigators also aim to study the inflammatory cytokines associated with cancer and how these markers respond to exercise. These inflammatory markers are thought to play a role in influencing some clinical outcomes such as wound infection and recovery.

The study will also assess secondary outcomes including hospital stay, post operative complications and quality of life. The investigators aim to better understand the biological relationship between anti-inflammatory cytokine levels and the previously mentioned outcomes by measuring and analysing these mediators and performing selected muscle biopsies.

Conditions

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Cancer of Colon Cancer of Rectum Liver Metastases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

1:1 randomisation to standard care or prehabilitation
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
CPET clinician/physiologist will be blinded

Study Groups

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Standard care

Standard Care: Surgery school as per ELHT pre-operative guidelines (includes generic pre-operative information, advice and optimisation e.g correction of anaemia)

Group Type NO_INTERVENTION

No interventions assigned to this group

Prehabilitation

Surgery School plus Moderate intensity exercise \& Forceval (multivitamin)

Group Type EXPERIMENTAL

Prehabilitation

Intervention Type OTHER

exercise \& multivitamin (nutritional/dietary advice)

Interventions

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Prehabilitation

exercise \& multivitamin (nutritional/dietary advice)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Aged 18-85
* Sex: male/female
* Radiological/tissue cancer diagnosis
* Curative cancer of the colon, rectum, colorectal liver metastases (CRLM) of 2 or more segments
* elective surgery (planned a minimum of 3 weeks from the date of first clinic meeting)
* Access to digital technology(mobile phone, tablet or laptop, home computer) to participate in supervised home exercise

Exclusion Criteria

Exclusion

* Palliative disease
* Haematological malignancy
* Pregnancy
* Emergency surgery
* Physically unable to undergo CPET
* Part of any other trial with similar interventions unless previously agreed on with all CIs
* synchronous disease (operation on HPB \& colorectal cancers at the same operation)
* No access to digital technology(smart phone, tablet, laptop or home computer)
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Lancaster University

OTHER

Sponsor Role collaborator

East Lancashire Hospitals NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Joel Lambert

Clinical Research Fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Joel Lambert

Role: PRINCIPAL_INVESTIGATOR

Senior Clinical Research Fellow

Chris Gaffney

Role: STUDY_DIRECTOR

Lancaster University

Locations

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Royal Blackburn Hospital

Blackburn, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Lambert JE, Hayes LD, Keegan TJ, Subar DA, Gaffney CJ. The Impact of Prehabilitation on Patient Outcomes in Hepatobiliary, Colorectal, and Upper Gastrointestinal Cancer Surgery: A PRISMA-Accordant Meta-analysis. Ann Surg. 2021 Jul 1;274(1):70-77. doi: 10.1097/SLA.0000000000004527.

Reference Type BACKGROUND
PMID: 33201129 (View on PubMed)

Related Links

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Other Identifiers

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290723

Identifier Type: -

Identifier Source: org_study_id

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