PDF(Pubmed)
Abstract：
Gastrointestinal (GI) cancers constitute over 25% of global cancer cases annually, with hepato-pancreato-biliary (HPB) cancers presenting particularly poor prognosis and challenging surgical treatments. While advancements in clinical care have improved post-operative outcomes over time, surgery for HPB cancers remains associated with high morbidity and mortality rates. Patients with HPB cancer are often older, diagnosed at later stages, and have a higher prevalence of co-morbid conditions, leading to reduced life expectancy, suboptimal post-operative recovery, and increased recurrence risk. Exercise and nutrition interventions have emerged as safe non-pharmacological strategies to enhance clinical outcomes among cancer survivors, but their potential in the pre-operative period for patients with HPB cancer remains underexplored. This narrative review evaluates existing evidence on exercise and nutritional interventions during pre-operative prehabilitation for HPB cancer populations, focusing on clinically relevant post-operative outcomes related to frailty and malnutrition. We conducted a literature search in PubMed and Google Scholar databases to identify studies utilizing a prehabilitation intervention in HPB cancer populations with exercise and nutritional components. The currently available evidence suggests that incorporating exercise and nutrition into prehabilitation programs offers a critical opportunity to enhance post-operative outcomes, mitigate the risk of comorbidities, and support overall survivorship among HPB cancer populations. This review underscores the need for further research to optimize the timing, duration, and components of pre-operative prehabilitation programs, emphasizing patient-centered, multidisciplinary approaches in this evolving field.
摘要：
胃肠道（GI）癌症每年占全球癌症病例的25％以上。肝胰胆管（HPB）癌症的预后特别差，手术治疗具有挑战性。虽然随着时间的推移，临床护理的进步改善了术后结果，手术治疗HPB癌症的发病率和死亡率仍然很高.HPB癌症患者通常年龄较大，在后期诊断，并且有较高的合并症患病率，导致预期寿命缩短，术后恢复欠佳，增加复发风险。运动和营养干预已成为提高癌症幸存者临床结局的安全非药物策略。但它们在术前对HPB癌症患者的潜力仍未得到充分开发。这篇叙述性综述评估了HPB癌症人群术前康复期间运动和营养干预的现有证据。重点关注与虚弱和营养不良相关的临床相关术后结局。我们在PubMed和GoogleScholar数据库中进行了文献检索，以确定在具有运动和营养成分的HPB癌症人群中利用康复干预的研究。目前现有的证据表明，将运动和营养纳入康复计划为提高术后效果提供了一个关键的机会。减轻合并症的风险，并支持HPB癌症人群的总体生存率。这篇综述强调了进一步研究以优化时机的必要性，持续时间,以及术前康复计划的组成部分，强调以患者为中心，这个不断发展的领域的多学科方法。
