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PREHAB showed that four weeks of supervised training, protein and support before bowel cancer surgery cut severe complications and sped recovery, in an international randomised trial of 251 patients.
PREHAB was an international multicentre randomised trial (Netherlands, Denmark, Canada, Italy) registered in the Netherlands Trial Register (NTR5947). Patients in the prehabilitation arm had a lower rate of severe complications (Comprehensive Complication Index over 20) and about half the number of medical complications, with faster functional recovery and no delay in surgery attributable to the programme. The intervention was resource-intensive (three supervised sessions a week for four weeks) and adherence was high in a trial setting. It is the strongest single randomised result for prehabilitation, complementing meta-analyses that show consistent improvements in functional capacity but heterogeneous effects on complications, and it underpins national programmes such as NHS England's with Macmillan.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
251 enrolled.
Odds ratio 0.47 (95% CI 0.26-0.87)
SourceMean difference 15.6 m (95% CI -1.4 to 32.6); not significant. Trial stopped early because of COVID-19.
SourceOdds ratio 0.48 (95% CI 0.26-0.89)
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Severe postoperative complications (Comprehensive Complication Index > 20)primary | Multimodal prehabilitation | 123 | 17.1% | - | 0.02 | link |
| Standard care (ERAS) | 128 | 29.7% | ||||
| Medical complications | Multimodal prehabilitation | - | 15.4% | - | 0.02 | link |
| Standard care (ERAS) | - | 27.3% | ||||
| 6-minute walking distance at 4 weeks post-operatively (change from baseline)primary | Multimodal prehabilitation | - | Mean difference 15.6 m (95% CI -1.4 to 32.6); not significant. Trial stopped early because of COVID-19. | - | 0.07 | link |
| Standard care (ERAS) | - | - |
Shares Prehabilitation (the pre-treatment window), What a prehabilitation programme actually contains, and how long it needs, Enhanced recovery (ERAS) and perioperative nutrition, What the randomised trials of prehabilitation found, operation by operation.
Shares Malnutrition screening tools (MUST, NRS-2002, MST, PG-SGA), Enhanced recovery (ERAS) and perioperative nutrition, Nutrition support and cachexia management, Fragmented care and guideline gaps.
Shares Multimodal prehabilitation for older patients before major cancer surgery, Four weeks of training and nutrition before major cancer surgery, as standard, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Exercise & lifestyle oncology.
Shares Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Exercise & lifestyle oncology, Colorectal cancer.
Shares Prehabilitation (the pre-treatment window), Enhanced recovery (ERAS) and perioperative nutrition.
Shares Malnutrition screening tools (MUST, NRS-2002, MST, PG-SGA), Enhanced recovery (ERAS) and perioperative nutrition, Nutrition support and cachexia management, Exercise & lifestyle oncology.
Shares Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Exercise & lifestyle oncology, Colorectal cancer.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Surgery and radiotherapy cure most, get least, Fragmented care and guideline gaps, Colorectal cancer.