Colorectal Neoplasm Clinical Trial
Official title:
Improving Outcomes in Patients With Hepatobiliary Cancers With a Nutritional and Physical Conditioning Pre-habilitation Program
1. To determine whether a combined nutritional support program and exercise-based
prehabilitation is superior to nutritional support alone in increasing functional
recovery and reducing post-operative morbidity after surgery for HPB malignancy.
2. To understand which measures of immediate surgical recovery are sensitive to
prehabilitation interventions and predict change in later outcome measures.
Status | Recruiting |
Enrollment | 64 |
Est. completion date | January 2015 |
Est. primary completion date | January 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: - Subjects eligible to enter the prehabilitation program will include those aged 18 and above and referred electively for resection of malignancies. Exclusion Criteria: - Excluded will be persons with American Society of Anesthesiologists (ASA) health status class 4-5 or co-morbid medical, physical and mental conditions (e.g. dementia, disabling orthopedic and neuromuscular disease, psychosis), cardiac abnormalities, severe end-organ disease such as cardiac failure, COPD, and hepatic failure (ALT and AST >50% over the normal range), and sepsis), morbid obesity (BMI >40), anemia (hematocrit < 30 %) and other conditions interfering with the ability to perform exercise at home or to complete the testing procedures. - Patients will be excluded if they have poor English or French comprehension. |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
Country | Name | City | State |
---|---|---|---|
Canada | Royal Victoria Hospital | Montreal | Quebec |
Lead Sponsor | Collaborator |
---|---|
McGill University Health Center |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in six minute walk test | The primary outcome is patient-relevant, functional walking capacity as measured by the six-minute walk test (6MWT). The 6MWT evaluates the ability of an individual to maintain a moderate level of physical activity over a time period reflective of the activities of daily living | 8 weeks pre-op and 1 week pre-op | No |
Secondary | post-operative complications | Postoperative complications including surgical site infection, other infectious complications (such as pneumonia, urinary tract infection, line sepsis), bile leak, hemmorrhage, deep vein thrombosis, etc., will be recorded and scored using the Clavien Classification. | 30 days | No |
Secondary | Health-related quality of life (HRQL) | Health-related quality of life (HRQL) as measured by the acute (1 week recall period) SF-36 health survey. The SF-36 is the most widely used HRQL measure and has been validated for surgical population; Canadian norms are also available. | 8 and 1 week pre-operatively, 4 and 8 weeks post-operatively | No |
Secondary | Physical activity level | Physical activity level will be measured through the Community Health Activities Model Program for Seniors (CHAMPS) questionnaire. The CHAMPS is a self-reported measure of physical activity, comprising 41 activities evaluated according to the total number of hours done during an average week. | 8 and 1 weeks pre-operatively, 4 and 8 weeks post-operatively | No |
Secondary | Depression and anxiety | Depression and anxiety will be assessed by The Hospital Anxiety and Depression Scale (HADS), a 14-question measure with seven items each for depression and anxiety. HADS generates separate scores for anxiety and depression as well as a combined score of psychological distress. | 8 and 1 weeks pre-operatively, 4 and 8 weeks post-operatively | No |
Secondary | Fatigue | Fatigue will be assessed using a visual analog scale (1-10) and the Brief Fatigue Inventory (BFI). The BFI assesses the level of fatigue and its impact on activities of daily living44 | 8 and 1 weeks pre-operatively, 4 and 8 weeks post-operatively | No |
Secondary | Nutritional status | Nutritional status will be assessed through subjective and objective evaluations.Body composition will be measured by bioimpedance assay.Assessment of usual food intake will be performed using the 3-day, 24-hour food recall method. The scored Patient Generated Subjective Global Assessment (sPG-SGA) is a validated questionnaire used to assess the nutritional and functional status of cancer patients. | 8 and 1 weeks pre-operatively, 4 and 8 weeks post-operatively | No |
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