Impact of prehabilitation on quality of life and mental health in patients awaiting cytoreductive surgery for ovarian cancer or suspected adnexal tumors.

BACKGROUND

Preoperative psychological distress and impaired quality of life are common in patients awaiting surgery for ovarian cancer or adnexal masses. We aimed to assess whether a multimodal prehabilitation program including physical exercise, nutritional support, and psychological counseling could improve quality of life and reduce anxiety and depression prior to surgery.

METHODS

In this prospective single-centre study, 145 patients were enrolled from May 2021 to May 2024 at a gynecologic oncology centre in Katowice, Poland. Baseline and post-intervention assessments included the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale (HADS). The prehabilitation program lasted on average 21.1 ± 16.7 days and combined physical exercise, nutritional support, and psychological counseling.

RESULTS

After completion of prehabilitation, global health status/quality of life scores improved modestly but significantly (mean change  ~2.5 points; p = 0.045). Mean HADS scores declined for anxiety (p = 0.003) and for depression (p = 0.028), indicating reductions in psychological distress.

CONCLUSIONS

Participation in a structured prehabilitation program was associated with improvements in overall quality of life and reductions in anxiety and depression in women awaiting gynecologic oncologic surgery, although the magnitude of these changes was modest. Notably, these improvements were observed despite the substantial psychological burden typically experienced during the preoperative period. These findings support incorporation of prehabilitation into standard preoperative care to better prepare patients both physically and mentally.