Research progress in preoperative pre-rehabilitation for patients with liver cancer

doi:10.3877/cma.j.issn.2095-3232.2025.05.017

Abstract

Abstract:

Surgery is the main treatment for liver cancer, featuring long operation time, high difficulty and severe trauma. Consequently, it is of significance to strengthen preoperative management of patients with liver cancer. Pre-rehabilitation is a preoperative management regimen based on the concept of enhanced recovery after surgery, aiming to obtain active recovery before surgery, including preoperative exercise, nutritional support and psychological intervention to optimize clinical outcome of surgical patients. In this article, the content, opportunity and individualization of pre-rehabilitation were reviewed, aiming to provide theoretical basis for preoperative pre-rehabilitation of liver cancer patients.

Key words: Carcinoma, hepatocellular, Surgery, Prehabilitation, Enhanced recovery after surgery (ERAS)

Anhai Yu, Wenkang Yuan, Jiale Chen, Chao Zhang, Chong Zhang. Research progress in preoperative pre-rehabilitation for patients with liver cancer[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(05): 775-779.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3232.2025.05.017

https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/Y2025/V14/I05/775

References 40

[1]	Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024[J]. CA Cancer J Clin, 2024, 74(1): 12-49. DOI: 10.3322/caac.21820.
[2]	谭妮, 郑海平, 欧超. 肝癌根治术治疗原发性肝癌患者的术后生存率及预后影响因素分析[J]. 现代肿瘤医学, 2019, 27(5): 826-829. DOI: 10.3969/j.issn.1672-4992.2019.05.027.
[3]	Gillis C, Ljungqvist O, Carli F. Prehabilitation, enhanced recovery after surgery, or both? A narrative review[J]. Br J Anaesth, 2022, 128(3): 434-448. DOI: 10.1016/j.bja.2021.12.007.
[4]	Berkel AEM, Bongers BC, Kotte H, et al. Effects of community-based exercise prehabilitation for patients scheduled for colorectal surgery with high risk for postoperative complications: results of a randomized clinical trial[J]. Ann Surg, 2022, 275(2): e299-e306. DOI: 10.1097/SLA.0000000000004702.
[5]	Molenaar CJL, Minnella EM, Coca-Martinez M, et al. Effect of multimodal prehabilitation on reducing postoperative complications and enhancing functional capacity following colorectal cancer surgery: the PREHAB randomized clinical trial[J]. JAMA Surg, 2023, 158(6): 572-581. DOI: 10.1001/jamasurg.2023.0198.
[6]	Barberan-Garcia A, Ubré M, Roca J, et al. Personalised prehabilitation in high-risk patients undergoing elective major abdominal surgery: a randomized blinded controlled trial[J]. Ann Surg, 2018, 267(1): 50-56. DOI: 10.1097/SLA.0000000000002293.
[7]	Koya S, Kawaguchi T, Hashida R, et al. Effects of in-hospital exercise on liver function, physical ability, and muscle mass during treatment of hepatoma in patients with chronic liver disease[J]. Hepatol Res, 2017, 47(3): E22-E34. DOI: 10.1111/hepr.12718.
[8]	Saran U, Guarino M, Rodríguez S, et al. Anti-tumoral effects of exercise on hepatocellular carcinoma growth[J]. Hepatol Commun, 2018, 2(5): 607-620. DOI: 10.1002/hep4.1159.
[9]	陈大宇, 卞晓洁, 刘金春, 等. 肝癌肝切除围术期的规范化营养药物治疗服务模式的研究[J]. 药学与临床研究, 2021, 29(3): 193-198. DOI: 10.13664/j.cnki.pcr.2021.03.009.
[10]	Yao H, Bian X, Mao L, et al. Preoperative enteral nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma: a strengthening the reporting of observational studies in epidemiology article[J]. Medicine, 2015, 94(46): e2006. DOI: 10.1097/MD.0000000000002006.
[11]	Levett DZH, Grimmett C. Psychological factors, prehabilitation and surgical outcomes: evidence and future directions[J]. Anaesthesia, 2019, 74(S1): 36-42. DOI: 10.1111/anae.14507.
[12]	Zhang H, Chen T, Ren J, et al. Pre-operative exercise therapy triggers anti-inflammatory trained immunity of Kupffer cells through metabolic reprogramming[J]. Nat Metab, 2021, 3(6): 843-858. DOI: 10.1038/s42255-021-00402-x.
[13]	Deprato A, Verhoeff K, Purich K, et al. Surgical outcomes and quality of life following exercise-based prehabilitation for hepato-pancreatico-biliary surgery: a systematic review and meta-analysis[J]. Hepatobiliary Pancreat Dis Int, 2022, 21(3): 207-217. DOI: 10.1016/j.hbpd.2022.02.004.
[14]	覃英容, 黄银英, 刘绍平, 等. 加速康复外科管理模式在原发性肝细胞癌的应用研究[J]. 中国医药科学, 2022, 12(3): 181-184.
[15]	Tew GA, Ayyash R, Durrand J, et al. Clinical guideline and recommendations on pre-operative exercise training in patients awaiting major non-cardiac surgery[J]. Anaesthesia, 2018, 73(6): 750-768. DOI: 10.1111/anae.14177.
[16]	Mylius CF, Krijnen WP, Takken T, et al. Objectively measured preoperative physical activity is associated with time to functional recovery after hepato-pancreato-biliary cancer surgery: a pilot study[J]. Perioper Med, 2021, 10(1): 33. DOI: 10.1186/s13741-021-00202-7.
[17]	Pressoir M, Desné S, Berchery D, et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres[J]. Br J Cancer, 2010, 102(6): 966-971. DOI: 10.1038/sj.bjc.6605578.
[18]	Li Q, Zhang X, Tang M, et al. Different muscle mass indices of the Global Leadership Initiative on Malnutrition in diagnosing malnutrition and predicting survival of patients with gastric cancer[J]. Nutrition, 2021, 89: 111286. DOI: 10.1016/j.nut.2021.111286.
[19]	Sánchez-Torralvo FJ, Ruiz-García I, Contreras-Bolívar V, et al. CT-determined sarcopenia in GLIM-defined malnutrition and prediction of 6-month mortality in cancer inpatients[J]. Nutrients, 2021, 13(8): 2647. DOI: 10.3390/nu13082647.
[20]	Matsui R, Rifu K, Watanabe J, et al. Impact of malnutrition as defined by the GLIM criteria on treatment outcomes in patients with cancer: a systematic review and meta-analysis[J]. Clin Nutr, 2023, 42(5): 615-624. DOI: 10.1016/j.clnu.2023.02.019.
[21]	Tsukagoshi M, Araki K, Igarashi T, et al. Lower geriatric nutritional risk index and prognostic nutritional index predict postoperative prognosis in patients with hepatocellular carcinoma[J]. Nutrients, 2024, 16(7): 940. DOI: 10.3390/nu16070940.
[22]	Montano-Loza AJ, Angulo P, Meza-Junco J, et al. Sarcopenic obesity and myosteatosis are associated with higher mortality in patients with cirrhosis[J]. J Cachexia Sarcopenia Muscle, 2016, 7(2): 126-135. DOI: 10.1002/jcsm.12039.
[23]	Jones A, Silver HJ. Myosteatotic and sarcopenic obesity impact postoperative outcomes more robustly than visceral obesity in general surgery patients, with differences by sex[J]. Clin Nutr, 2023, 42(5): 625-635. DOI: 10.1016/j.clnu.2023.03.005.
[24]	Bozzetti F, Gianotti L, Braga M, et al. Postoperative complications in gastrointestinal cancer patients: the joint role of the nutritional status and the nutritional support[J]. Clin Nutr, 2007, 26(6): 698-709. DOI: 10.1016/j.clnu.2007.06.009.
[25]	Bozzetti F, Mariani L. Perioperative nutritional support of patients undergoing pancreatic surgery in the age of ERAS[J]. Nutrition, 2014, 30(11-12): 1267-1271. DOI: 10.1016/j.nut.2014.03.002.
[26]	Booi AN, Menendez J, James Norton H, et al. Validation of a screening tool to identify undernutrition in ambulatory patients with liver cirrhosis[J]. Nutr Clin Pract, 2015, 30(5): 683-689. DOI: 10.1177/0884533615587537.
[27]	Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients[J]. Clin Nutr, 2017, 36(1): 11-48. DOI: 10.1016/j.clnu.2016.07.015.
[28]	中华医学会外科学分会, 中华医学会麻醉学分会. 中国加速康复外科临床实践指南(2021版)[J]. 中国实用外科杂志, 2021, 41(9): 961-992. DOI: 10.19538/j.cjps.issn1005-2208.2021.09.01.
[29]	Gillis C, Wischmeyer PE. Pre-operative nutrition and the elective surgical patient: why, how and what?[J]. Anaesthesia, 2019, 74(Suppl 1): 27-35. DOI: 10.1111/anae.14506.
[30]	Manou-Stathopoulou V, Korbonits M, Ackland GL. Redefining the perioperative stress response: a narrative review[J]. Br J Anaesth, 2019, 123(5): 570-583. DOI: 10.1016/j.bja.2019.08.011.
[31]	Mavros MN, Athanasiou S, Gkegkes ID, et al. Do psychological variables affect early surgical recovery?[J]. PLoS One, 2011, 6(5): e20306. DOI: 10.1371/journal.pone.0020306.
[32]	Scheede-Bergdahl C, Minnella EM, Carli F. Multi-modal prehabilitation: addressing the why, when, what, how, who and where next?[J]. Anaesthesia, 2019, 74(Suppl 1): 20-26. DOI: 10.1111/anae.14505.
[33]	袁志蓉, 周浩明, 孙克莲, 等. 三联预康复策略在老年腹腔镜肝切除患者中的应用效果[J]. 腹腔镜外科杂志, 2024, 29(2): 155-157. DOI: 10.13499/j.cnki.fqjwkzz.2024.02.155.
[34]	冯碧, 许瑞华. 三联预康复策略在肝癌腹腔镜肝切除术中的应用价值[J]. 现代肿瘤医学, 2019, 27(10): 1761-1765.
[35]	李纪宾, 邹小农. 《2016年中国癌症发病和死亡情况》解析[J]. 环境卫生学杂志, 2023, 13(1): 45-47, 53. DOI: 10.13421/j.cnki.hjwsxzz.2023.01.006.
[36]	安然, 张超. 腹腔镜肝切除术中出血预防和控制[J/OL]. 中华肝脏外科手术学电子杂志, 2020, 9(2): 123-126. DOI: 10.3877/cma.j.issn.2095-3232.2020.02.007.
[37]	Yue T, Zhang Q, Cai T, et al. Trends in the disease burden of HBV and HCV infection in China from 1990-2019[J]. Int J Infect Dis, 2022, 122: 476-485. DOI: 10.1016/j.ijid.2022.06.017.
[38]	Toh MR, Wong EYT, Wong SH, et al. Global epidemiology and genetics of hepatocellular carcinoma[J]. Gastroenterology, 2023, 164(5): 766-782. DOI: 10.1053/j.gastro.2023.01.033.
[39]	陈曦阳光, 吴君. 乙型肝炎肝硬化并发原发性肝癌相关危险因素Meta分析[J]. 肝脏, 2019, 24(4): 398-404. DOI: 10.14000/j.cnki.issn.1008-1704.2019.04.019.
[40]	Wang MD, Li C, Liang L, et al. Early and late recurrence of hepatitis B virus-associated hepatocellular carcinoma[J]. Oncologist, 2020, 25(10): e1541-e1551. DOI: 10.1634/theoncologist.2019-0944.

Please choose a citation manager

Content to export