Patients allocated to the intervention group will undergo prehabilitation protocol (nutrition + exercise + psychological counselling), with individualized monitoring by the multidisciplinary team.

Patients allocated to the control group will not undergo any pre-surgical intervention, except for preoperative counselling, already implicated in ERAS®.

Prehabilitation Program (nutrition + exercise + psychological counseling) + ERAS protocol

Prehabilitation Program + Enhanced Recovery After Surgery

Enhanced Recovery After Surgery

Andre Lopes, MD

Prospective, interventionist, controlled and randomized study to test the effectiveness of multimodal prehabilitation protocol in patients who will undergo gynecological surgery.

Prospective, interventionist and randomized controlled trial in a 1: 1 ratio, open to the multidisciplinary team but blind to surgeons and anaesthesiologists. The aim is to test the effectiveness of a multimodal prehabilitation protocol in patients with diagnosed or suspicious gynaecological cancer, who will undergo gynaecological surgery.

The multidisciplinary prehabilitation program will be applied to the intervention group. For the group participating in the prehabilitation and for the control group, the protocol and specific recommendations for gynecological cancer defined by the Enhanced Recovery After Surgery (ERAS®) guidelines will be applied.

Single-Blind (surgeons and anesthesiologists)

Prehabilitation Plus ERAS vs ERAS in Gynecological Surgery

Prehabilitation Plus Enhanced Recovery After Surgery Versus Enhanced Recovery After Surgery in Gynecological Surgery

Postoperative day patient is ready for discharge, defined as the day the patient has the ability to walk alone, take care of herself, and ingest at least 75% of the daily caloric needs

Postoperative Intensive Care Unit admission and stay

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)

Compliance to ERAS® protocol and implementation of the program

Changes in anxiety and depression will be examined using the Hospital Anxiety and Depression Scale. Scores for each sub scale (depression and anxiety) are summed-up and range from 0 to 21. Values from 0-7 indicate normal levels, 8-10 are border values and values from 11-21 are considered to be pathological.

Patients will perform a 6-Minute Walk Test

Muscle strength is measured by using an dynamometer

Body mass is measured by using a bioelectrical impedance analysis

Days from surgical procedure to hospital discharge

Instituto Brasileiro de Controle do Cancer

Alayne Yamada, PhD

Prospective, interventionist, controlled and randomized study to test the effectiveness of a multimodal prehabilitation protocol in patients who will undergo gynecological surgery.

Prospective, interventionist and randomized controlled trial in a 1: 1 ratio, open to multidisciplinary team and blind to surgeons and anaesthesiologists. The aim is test the effectiveness of a multimodal prehabilitation protocol in patients who will undergo gynecological surgery.

The multidisciplinary prehabilitation program will be applied to the intervention group. For the group participating in the prehabilitation and for the control group, specific recommendations for gynecological cancer defined by the Enhanced Recovery After Surgery (ERAS®) guidelines will be applied.

Prehabilitation Plus ERAS Versus ERAS in Gynecologic Oncology: a Randomized Clinical Trial

Prehabilitation Plus Enhanced Recovery After Surgery Versus Enhanced Recovery After Surgery in Gynecologic Oncology: a Randomized Clinical Trial

Complications and Adverse Effects according to Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 2017

Use and dosage of opioids in the postoperative period

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Prehabilitation Plus ERAS vs ERAS in Gynecological Surgery	NCT04505111	Gynecologic Sur... Enhanced Recove...	Prehabilitation... Enhanced Recove...	18 Years - 80 Years	Instituto Brasileiro de Controle do Cancer
Prehabilitation Plus ERAS Versus ERAS in Gynecologic Oncology: a Randomized Clinical Trial	NCT04596800	Gynecologic Can... Enhanced Recove...	Prehabilitation... Enhanced Recove...	18 Years - 80 Years	Instituto Brasileiro de Controle do Cancer

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