A consensus opinion on the best prehabilitation strategies for Upper GI cancer patients

Abstract Background Upper GI (UGI) cancer patients face substantial physical and functional challenges which can compromise postoperative recovery. Prehabilitation, a proactive multidisciplinary intervention, offers a promising approach to optimize patient outcomes. This Delphi exercise aims to gather a consensus on the effectiveness of various prehabilitation strategies and interventions in improving functional capacity, reducing treatment-related complications, and enhancing quality of life among UGI cancer patients. Methods We performed a Delphi exercise in the form of an online survey emailed to a group of surgeons, anaesthetists, specialist nurses and allied healthcare professionals involved in the perioperative care of UGI cancer patients. A 2-staged iterative process was used to gather consensus on clinical practice and expert opinion. In the second round the survey was refined to evaluate specific strategies of prehabilitation more closely. Results In the first round, 14 statements were evaluated in addition to basic demographic data, information about the unit and clinician experience. 161 responses were collected from surgeons, anaesthetists, specialist nurses and allied healthcare professionals. Consensus was reached on formal assessment of patient fitness pre-operatively. However no consensus was achieved in the best method for doing so. In the second round we evaluated 22 statements after refining the questions to specifically target prehabilitation exercises and formal fitness assessments available for the perioperative care of UGI cancer patients. Conclusions Prehabilitation interventions hold significant potential in optimizing outcomes and improving the quality of life for UGI cancer patients undergoing major surgery. This Delphi exercise provides multidisciplinary expert consensus statements which can help guide clinicians in day-to-day practice as well as provide a basis for future guidelines and recommendations.