Evidence Explorer · MS-N247 · Exercise and rehabilitation · postoperative pulmonary complications and functional capacity · Appraised November 5, 2026
A randomized trial found that a median eight-day aerobic, resistance and respiratory prehabilitation program improved preoperative walking capacity but did not reduce pulmonary complications or other clinical and patient-reported outcomes after liver-cancer surgery.
Evidence at a glance
- Benefit signal: Preoperative six-minute-walk distance improved; no demonstrated reduction in pulmonary complications.
- Certainty: Moderate for the tested short program, though the brief duration may limit the achievable effect.
- Risk context: Preoperative exercise should not delay indicated surgery and must account for liver function, anemia, cardiopulmonary risk and falls.
- Cancer-control relevance: No tumor-response, recurrence or survival benefit was established.
What was studied
The trial randomized 205 people scheduled for liver-cancer surgery: 104 to a combined aerobic, resistance and respiratory exercise program and 101 to usual care.
The median intervention period was eight days, reflecting the short preoperative window.
What the study found
Pulmonary complications did not differ: adjusted odds ratio 0.70 (95% CI 0.37 to 1.29; p=0.249). Other clinical and patient-reported outcomes also did not differ.
Before surgery, six-minute-walk distance was 33.36 m higher with prehabilitation (95% CI 22.02 to 44.70; p<0.001). The study did not establish that this translated into fewer complications.
What this does not establish
Improved walking distance is not a substitute for a clinical endpoint. The study does not rule out benefit from longer or differently targeted prehabilitation, and it does not support delaying cancer surgery to complete an exercise program.
Safety and practical context
The surgical team should define the safe window and any restrictions. Ascites, encephalopathy, variceal bleeding risk, severe anemia or cardiopulmonary instability can change suitability.
Stop for chest pain, syncope, new confusion, bleeding, severe breathlessness or acute abdominal symptoms.
Questions for the care team
- How much time is safely available before surgery?
- Which complication risk is the program intended to address?
- Can exercise begin without delaying imaging, clearance or the operation?
Sources and identifiers
Funding and conflicts: Not fully verified from the accessible abstract.
Source access and dates: Primary abstract was appraised; full adherence, adverse-event and disclosure tables were not independently verified. Sources checked November 5, 2026. Last literature search November 5, 2026.
Educational evidence summary, not individualized medical advice. Exercise around cancer treatment should be adapted to symptoms, blood counts, bone health, cardiopulmonary status, surgical restrictions and the treating team’s guidance.
