389 the Effect of a Multimodal Prehabilitation Programme on Preoperative Functional Capacity and Anthropometrics of Gynaecological Oncology Patients

Introduction/Background Prehabilitation, a preoperative optimization intervention, remains in its infancies within gynaecological oncology. Little is known about the direct effects of such programmes on functional capacity. It is paramount to evaluate these effects to subsequently determine the relation with postoperative outcomes. Therefore, this study aims to assess the direct effect of multimodal prehabilitation on functional status for gynaecological oncology patients. Methodology This was an analysis of the F4S PREHAB trial, a monocentre stepped-wedge trial, to assess the direct effect of multimodal prehabilitation on functional capacity. Participants were patients scheduled for surgical treatment for ovarian, endometrial or vulvar cancer between May 2021 and September 2023 at the Radboudumc, Nijmegen, The Netherlands. Multimodal prehabilitation included an exercise, nutritional and psychological component, a smoking cessation programme and screening for frailty and comorbidities. We compared functional capacity before and after participation in the programme. Aspects of functional capacity assessed were estimated VO2max, indirect 1-Repetition Maximum tests (1-RM), Timed Chair Stand Test (5CST), grip strength and PG-SGA scores. Multivariate analyses were used to correct for possible confounding factors such as age, BMI, ASA-score, comorbidities, haemoglobin and histology. Results A total of 107 participants were included in the intervention group. Median duration of the programme was twenty days (range 7–62). When assessing the effect of multimodal prehabilitation on physical fitness, significant improvements in VO2max were seen by 0.83 ml/kg/min (P=0.017), in indirect 1-RM by 16 kg (p<0.001), and grip strength by 1.2kg (p=0.008). The results from the Timed Chair Test (5-CST) significantly shortened by half a second (p=0.001). Significantly more participants had a low risk on malnutrition after multimodal prehabiliation compared to before (62% vs 70%; p=0.005), and a significant reduction by 1 point in PG-SGA score was found (p=0.002). Conclusion This study demonstrates that multimodal prehabiliation has the ability to improve functional capacity preoperatively for gynaecological oncology patients. Disclosures None to disclose.