Long‐term results of a short‐term home‐based pre‐ and postoperative exercise intervention on physical recovery after colorectal cancer surgery (PHYSSURG‐C): a randomized clinical trial

Abstract Aim The aim of this work was to assess the effect of a short‐term, home‐based exercise intervention before and after colorectal cancer surgery on 12‐month physical recovery within a previously reported randomized control trial (RCT). Method PHYSSURG‐C is an RCT in six participating hospitals in Sweden. Patients aged ≥20 years planned for elective colorectal cancer surgery were eligible. The intervention consisted of unsupervised moderate‐intensity physical activity 2 weeks preoperatively and 4 weeks postoperatively. Usual care was control. The primary outcome measure in PHYSSURG‐C was self‐assessed physical recovery 4 weeks postoperatively. The predefined long‐term follow‐up outcomes included: self‐assessed physical recovery 12 months postoperatively and reoperations and readmissions 91–365 days postoperatively. The statistical models were adjusted with tumour site (colon or rectum), neoadjuvant therapy (none, radiotherapy or chemo/radiotherapy) and type of surgery (open or laparoscopic). Results A total of 616 participants were available for the 12‐month follow‐up. Groups were balanced at baseline regarding demographic and treatment variables. There was no effect from the intervention on self‐reported physical recovery [adjusted odds ratio (OR) 0.91, p = 0.60], the risk of reoperation (OR 0.97, p = 0.91) or readmission (OR 0.88, p = 0.58). Conclusion The pre‐ and postoperative unsupervised moderate‐intensity exercise intervention had no effect on long‐term physical recovery after elective colorectal cancer surgery. There is still not enough evidence to support clinical guidelines on preoperative exercise to improve outcome after colorectal cancer surgery.