San Diego, CA USA (UroToday.com) In this session, Dr. Montgomery and the group from Ann Arbor presented the interim results of a phase 1-2 study looking at prehabilitation (i.e. rehabilitation prior to any intervention) for patients with muscle-invasive bladder cancer undergoing radical cystectomy.
Patients greater than 60 years old were asked to exercise in a 1:1 supervised setting with a certified personal trainer 3 times per week for 4 weeks before surgery. Fitness and quality of life (QOL) measures were obtained at baseline and after completing the exercise course. QOL was reevaluated at 30 and 90 days after surgery.
Twenty-two patients with mean age 71.8 years and median Charlson comorbidity index (CCI) of 6 were included. Patients were able to attend approximately 75% of all exercise sessions and there were no adverse events. Mean length of hospital stay was 7.1 days. Ninety-day readmission and any complication rates were 36.1% and 73.1%, respectively. Compared to baseline levels, patients improved their 15-foot walk test by 20 seconds, 6-minute walk distance by 53 feet, and submaiximal exercise test VO2 by 1.7ml/kg/min. Relative to baseline, normative SF-36 scores improved for the physical general health, vitality, mental health, and physical composite score domains. Pysical and vitality domain scores decreased after surgery, but returned to baseline by day 90. General health and mental health scores improved throughout the duration of the study.
The authors concluded that prehabilitation in cystectomy patients is feasible, safe, and results in improvement in fitness and endurance parameters. Complication and readmission rates unfortunately remain high despite prehabilitation. Further recruitment to this study is ongoing.
Presented By: Jeffrey Montgomery, MD