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Active, not recruitingNCT04223401PREFOGUpdated Nov 8, 2023

Prehabilitation for Gastrectomy

An interventional study of Prehabilitation in Gastric Cancer, sponsored by National Cancer Center Affiliate of Vilnius University Hospital Santaros Klinikos. Active, not recruiting at 2 sites in Lithuania. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-11-08.

Sponsored by National Cancer Center Affiliate of Vilnius University Hospital Santaros Klinikos · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
128
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Prehabilitation has been demonstrated to be an effective strategy to improve outcomes in patients undergoing some of the abdominal operations. It may increase the physical capacity of the patient, improve postoperative quality of life and even decrease the postoperative morbidity. Currently, the most effective strategy seems to be a trimodal prehabilitation which includes: 1) Nutritional support 2) Psychological support and 3) Physical training.

Read the detailed description

This study will investigate personalized trimodal prehabilitation for patients undergoing gastrectomy for gastric cancer.

Prehabilitation group:

Patients will undergo 6 Minutes Walking Test (6-MWT), spiroergometry (VO2 max; AT), a grip strength test, a timed Up \& Go (TUG) test, 10 m sprint test and sit to stand test before and after prehabilitation. The trimodal intervention will involve:

  1. Nutritional intervention: The dietetic physician will perform physical examination and evaluation of the nutritional status to provide individualized care to each patient. Patients will receive personalized recommendations for the prevention or correction of malnutrition.
  2. Psychological intervention: Patients will undergo consultation by specialized onco-psychologist. The anxiety and depression level will be evaluated by HAD score and patients will be trained to perform techniques, such as relaxation to reduce and manage anxiety on at home basis.

    The psychologist also will enhance patients' motivation to comply with the exercise and nutritional aspects of the intervention.

  3. Exercise intervention: Patients will be consulted by PM\&R physicians and physiotherapists and personalized exercise plans will be developed according to the results of 6MWT, AT and VO2peak. Exercises will focus on skeletal muscles and cardiopulmonary function training and the exercises feasible at home basis will be selected. All patients will undergo three supervised training sessions to learn the correct exercise techniques.

All patients will be routinely contacted to ensure compliance with prehabilitation program.

Patients scheduled for surgery first by multidisciplinary tumor board will undergo 4 weeks prehabilitation program, while patients scheduled for perioperative chemotherapy will undergo prehabilitation while neoadjuvant treatment will be administered.

Control group:

Patients will also undergo 6 Minutes Walking Test (6-MWT), spiroergometry (VO2 max; AT), a grip strength test, a timed Up \& Go (TUG) test, 10 m sprint test and sit to stand test before surgery or before and after neoadjuvant chemotherapy. Patients will not undergo prehabilitation.

02

Conditions studied

  • Gastric Cancer

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patient ≥ 18 years old
  • Patient agrees to participate in a clinical study
  • Patient requires surgical treatment for gastric cancer

Exclusion criteria

Exclusion Criteria:

  • Patient requiring surgical treatment for recurrent gastric cancer
  • Patient condition not allowing to postpone surgery for at least 4 weeks
  • Patients physical or mental condition which will not allow the patient to participate in prehabilitation program
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
128 participants (estimated)

Study arms

  • Experimental
    Prehabilitation group

    Patients in the experimental group will undergo prehabilitation before the elective surgery for gastric cancer.

    Other: Prehabilitation

  • No intervention
    Control group

    Patients in the control group will not undergo prehabilitation.

Interventions

  • OtherPrehabilitation

    Patients will undergo 6 Minutes Walking Test (6-MWT), spiroergometry (VO2 max; AT), a grip strength test, a timed Up \& Go (TUG) test, 10 m sprint test and sit to stand test before and after prehabilitation. The trimodal intervention will involve: 1. Nutritional intervention 2. Psychological intervention 3. Exercise intervention

05

What researchers measure

Primary outcomes

  1. Postoperative morbidity rate by Clavien-Dindo

    Time frame: At 90 days postoperatively

Secondary outcomes

  1. Physical status by Spiroergometry

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  2. Physical status by International Physical Activity Questionnaire (IPAQ)

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  3. Postoperative mortality rate

    Time frame: At 30 and 90 days postoperatively

  4. Nutritional status by albumin level

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  5. Quality of Life by EORTC questionnaires

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  6. Percentage of patients reaching the complete oncological treatment fixed in a multidisciplinary tumour board (including preoperative chemotherapy, surgery and postoperative chemotherapy)

    Time frame: 12 months after surgery

  7. Physical status by grip strength test

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  8. Physical status by 6 minutes walk test

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  9. Physical status by the sit to stand test

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  10. Physical status by the timed up&go test

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

  11. Psychological status by Hospital Anxiety and Depression Scale (HADS).

    Time frame: Baseline, pre-surgery, 3, 6 and 12 months after surgery

06

Study locations

2 sites
  • National Cancer Institute
    Vilnius, 09239, Lithuania
  • Vilnius University hospital Santaros klinikos
    Vilnius, Lithuania
07

References and documents

Publications

  • Bausys A, Luksta M, Kuliavas J, Anglickiene G, Maneikiene V, Gedvilaite L, Celutkiene J, Jamontaite I, Cirtautas A, Lenickiene S, Vaitkeviciute D, Gaveliene E, Klimaviciute G, Bausys R, Strupas K. Personalized trimodal prehabilitation for gastrectomy. Medicine (Baltimore). 2020 Jul 2;99(27):e20687. doi: 10.1097/MD.0000000000020687. PubMed 32629639 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT04223401
Lead sponsor
National Cancer Center Affiliate of Vilnius University Hospital Santaros Klinikos
Collaborators
Vilnius University, Vilnius University Hospital Santaros Klinikos
Responsible party
Sponsor
First posted
Jan 10, 2020
Start date
Feb 6, 2020
Primary completion
Oct 1, 2023
Completion
Dec 31, 2023 (estimated)
Last update
Nov 8, 2023

Study contacts

Kestutis Strupas, MD PhD Prof.
principal investigator · Vilnius University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is active, not recruiting, as verified in Nov 2023. You cannot join it, but the record below documents what was studied.

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