SynthesisJournal of gastrointestinal cancer2026
Unimodal to Multimodal Prehabilitation in Gastric Cancer Surgery: Systematic Review of Randomised Controlled Trials.
Synthesis in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Authors and funding
5 authors.
Funding
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Abstract
purposePrehabilitation prior to gastric cancer resection aims to optimise pre-operative physical and nutritional status to improve perioperative resilience. However, the current evidence-base is fragmented. This review synthesized randomized controlled trial (RCT) evidence evaluating effectiveness of prehabilitation interventions prior to gastric cancer resection and characterized reported outcomes.
methodsA systematic review was conducted following PRISMA guidelines (PROSPERO registration -CRD420251233981). MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL were searched up to August 2025. Eligible studies were RCTs investigating unimodal or multimodal prehabilitation interventions (minimum duration 7 days) prior to gastric cancer resection. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Heterogeneity precluded meta-analysis and results were synthesized narratively.
resultsFourteen RCTs were included: four multimodal, and ten unimodal interventions (nutritional (n = 9), spirometry (n = 1)), duration range (7-days to 15-weeks). Fifty-three unique outcomes were reported across five domains: clinician/observer-reported outcomes, performance outcomes, patient-reported outcomes, biomarkers, and non-health outcomes. Multimodal prehabilitation programs suggest potential benefits; fewer postoperative complications, and improved functional capacity. Short-duration unimodal nutritional interventions demonstrated mixed effects, although immune-nutrition and targeted supplementation reduced infectious complications in malnourished patients. Findings were limited by risk-of-bias (some concerns (n = 7), high (n = 7)).
conclusionPrehabilitation in gastric cancer surgery demonstrated a potential benefit, particularly when delivered as multimodal interventions. However, the evidence base is limited by substantial heterogeneity, variable methodological quality, and inconsistent outcome reporting. Development of a disease-specific core outcome set is urgently required, in addition to adequately powered, risk-stratified trials to advance evidence synthesis and implementation of gastric cancer prehabilitation.
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Registered trials
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