Multidimensional Prehabilitation in Pancreatic Surgery for Pancreatic and Periampullary Neoplasms

NCT ID: NCT05225038

Last Updated: 2024-09-19

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

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-13

Study Completion Date

2023-10-30

Brief Summary

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Randomized Clinical Trial Investigating Multidimensional Prehabilitation in Pancreatic Surgery for participants with Pancreatic and Periampullary Neoplasms

Detailed Description

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Frailty is independently associated with an increased risk of adverse outcomes after major surgery, including pancreatic resection. Prehabilitation aims to optimize modifiable risk factors to improve participants' baseline health prior to surgery. Multiple studies with participants undergoing pancreatic surgery have investigated the impact of prehabilitation on preoperative health metrics as well as postoperative outcomes. The majority of these studies focused only on exercise; if nutritional and/or psychological status were assessed, these dimensions were not intervened upon in prehabilitation regimens or reassessed postoperatively. This randomized controlled trial (RCT) is designed to assess the impact of physical and nutritional prehabilitation on participants' perioperative condition for those undergoing pancreatic resection for diagnosed or suspected pancreatic and periampullary neoplasms.

Conditions

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Pancreatic Neoplasms Periampullary Carcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Control Arm (Standard of Care)

Participants will receive the current standard preoperative education and counseling. Participants will receive information regarding exercise and nutrition from a member of the surgical team. Participants will meet with a behavioral medicine specialist for additional education regarding factors affecting postoperative stress and relaxation techniques. Participants who are actively smoking will be counseled regarding smoking cessation and offered a referral to smoking cessation resources.

Group Type ACTIVE_COMPARATOR

Behavioral Medicine

Intervention Type BEHAVIORAL

Participants will have 1 appointment with behavioral medicine - all participants will meet with the same behavioral medicine specialist to ensure consistency. Participants will receive education regarding factors that affect postoperative recovery and relaxation techniques.

Participants will also have the option to request faith support.

Smoking Cessation

Intervention Type BEHAVIORAL

Participants who are actively smoking will be counseled regarding smoking cessation during their preoperative appointment with a member of the surgical team. They will also be offered a referral to smoking cessation resources.

Intervention Arm (Prehabilitation)

Participants in the intervention arm will receive all of the standard of care, as listed above, as well as individualized exercise and nutritional prehabilitation regimens.

During the data analysis, participants will be subdivided into treatment groups, upfront surgical resection versus neoadjuvant chemotherapy, in order to determine whether length of prehabilitation affected outcomes and distinguish any possible effect of chemotherapy toxicity.

Group Type EXPERIMENTAL

Exercise

Intervention Type OTHER

Participants will meet with an exercise physiologist to undergo evaluation and develop individualized regimens for prehabilitation.

Nutritional

Intervention Type DIETARY_SUPPLEMENT

Participants will meet with a nutritionist to undergo evaluation and develop individualized regimens for prehabilitation.

Behavioral Medicine

Intervention Type BEHAVIORAL

Participants will have 1 appointment with behavioral medicine - all participants will meet with the same behavioral medicine specialist to ensure consistency. Participants will receive education regarding factors that affect postoperative recovery and relaxation techniques.

Participants will also have the option to request faith support.

Smoking Cessation

Intervention Type BEHAVIORAL

Participants who are actively smoking will be counseled regarding smoking cessation during their preoperative appointment with a member of the surgical team. They will also be offered a referral to smoking cessation resources.

Interventions

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Exercise

Participants will meet with an exercise physiologist to undergo evaluation and develop individualized regimens for prehabilitation.

Intervention Type OTHER

Nutritional

Participants will meet with a nutritionist to undergo evaluation and develop individualized regimens for prehabilitation.

Intervention Type DIETARY_SUPPLEMENT

Behavioral Medicine

Participants will have 1 appointment with behavioral medicine - all participants will meet with the same behavioral medicine specialist to ensure consistency. Participants will receive education regarding factors that affect postoperative recovery and relaxation techniques.

Participants will also have the option to request faith support.

Intervention Type BEHAVIORAL

Smoking Cessation

Participants who are actively smoking will be counseled regarding smoking cessation during their preoperative appointment with a member of the surgical team. They will also be offered a referral to smoking cessation resources.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Participants \> 18 years old with ECOG performance status 0-2 and ASA score ≤3
* Requiring pancreatic resection for diagnosed or suspected pancreatic and periampullary neoplasms
* Surgery scheduled at least 2 weeks after the initial surgical evaluation
* Fluency in English

* Willingness to answer questionnaires, complete daily exercise \& nutrition log, as well as participate in follow-up telephone calls
* Screening: Physical Activity Readiness - Questionnaire (PAR-Q+)

* PAR-Q+ assesses participants comorbidities and symptoms with current activities. If participants answer "yes" to any of the screening questions, they will need to complete additional questions regarding their chronic medical conditions including, but not limited to, heart disease, stroke, diabetes, depression/anxiety, and COPD/asthma, to determine their ability to participate in physical activity.

Exclusion Criteria

* Screening: Physical Activity Readiness - Questionnaire (PAR-Q+)

* Participants with concurrent medical conditions that prohibit exercise, such as those who indicate on the questionnaire that they experience chest pain, dizziness, or loss of consciousness with physical activity; those with chest pain at rest; or those with bone/joint/soft tissue conditions that could worsen with physical activity. Participants with specific comorbidities, such as coronary artery disease. congestive heart failure, or uncontrolled asthma/COPD, that may prevent participation will also be excluded.
* Inability to provide own informed consent
* Inability to read or verbally understand questionnaires in English
* Impaired hearing that creates a barrier for telephone follow-up
* Visual deficit that would cause exercise to be hazardous
* Emergent or urgent surgeries
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Case Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Cleveland Clinic Taussig Cancer Center, Case Comprehensive Cancer Center

Cleveland, Ohio, United States

Site Status

Countries

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United States

Other Identifiers

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CASE8221

Identifier Type: -

Identifier Source: org_study_id

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