Remote pre-habilitation in patients with cachexia and resectable gastric cancer: a case series

Background. The high rate of functional impairment and nutritional deficiency in patients with localized and locally advanced gastric tumors led to the concept of "pre-habilitation". Multimodal pre-habilitation refers to a combination of physical therapy, nutritional support, and psychological counseling during the preparation of patients for antitumor treatment. Aim. To present the outcomes of patients with cachexia after the program of remote multimodal pre-habilitation before surgical treatment of gastric cancer. Materials and methods. The outcomes of 10 patients with resectable gastric cancer and cancer cachexia were analyzed. Patients underwent comprehensive preoperative preparation, including nutritional support, physical therapy, and remote psychological counseling. Results. There was an improvement in functional parameters: an increase in walking speed in 8 patients, an increase in hand grip strength measured by dynamometry in 7 patients, and an increase in exercise tolerance in 2 patients. No early or late postoperative complications were reported. Conclusion. Multimodal remote pre-habilitation is a promising option for preparing patients with cachexia for surgical treatment of gastric cancer.