Ovarian cancer and multimodal prehabilitation options – a case study

Česká verze

Authors: Petra Sládková ^1,2 ; Marie Tichá ^1,2 ; M. Švábenická ^1,2 ; K. Kotrbová ^1,2 ; A. Šályová ¹ ; Z. Vlastníková ¹ ; M. Janatová ² ; K. Hoidekrová ^3,4 ; Markéta Polková ⁵ ; Michal Zikán ⁵ ; Tomáš Brtnický ⁵
Authors place of work: Klinika rehabilitace FN Bulovka, Praha ¹; Fakulta biomedicínského inženýrství, ČVUT, Kladno ²; 1. lékařská fakulta UK, Praha ³; Rehabilitační nemocnice Beroun, Beroun ⁴; Gynekologicko-porodnická klinika 1. LF UK a FN Bulovka, Praha ⁵
Published in the journal: Ceska Gynekol 2026; 91(1): 41-45
Category: Kazuistika
doi: https://doi.org/10.48095/cccg202641

Summary

Objective: The aim of this case report is to present the impact of multimodal prehabilitation on the quality of life, cognitive performance, physical fitness, and nutritional status in a patient with advanced ovarian cancer. Methods: A 74-year-old woman with high grade serous ovarian carcinoma pT3bN1a was scheduled for radical surgery following three cycles of neoadjuvant chemotherapy. She underwent a three-week intensive multimodal prehabilitation program in a 4/7 regimen involving physiotherapy, occupational therapy, nutritional counselling, psychological support, and supervision by a rehabilitation physician. The effect was evaluated using functional and cognitive tests, stress and disability scales, and body composition analysis (InBody). Results: Improvement was observed across all major domains: reduction in disability (WHODAS 20 ® 5%), enhancement of cognitive function (MoCA 22 ® 25), decreased perceived stress (PSS-10 17 ® 11), reduction in frailty (FI 3 ® 1), and restoration of full independence in activities of daily living (Katz Index 6/6). Physical performance showed marked gains (6MWT +42 m, 5×SST −6.5 s, handgrip strength +4 kg), while pulmonary function tests confirmed improved ventilatory capacity (FVC, FEV1, PEF). Nutritional assessment indicated a reduced risk of malnutrition according to the MUST screening tool, although bioimpedance analysis demonstrated a mild increase in total body fat and visceral adipose tissue. Conclusion: Intensive multimodal prehabilitation positively influenced the patient’s psychosensory-motor potential, reduced disability, enhanced perioperative fitness, and confirmed its indispensable role in oncogynecology.

Keywords:

disability – Quality of life – oncogynecology – prehabilitation

Zdroje

1. Lednický Š, Cibula D, Slabá Š. Prehabilitace. Ceska Gynekol 2020; 85 (5): 352–356.

2. Malecová M, Kabele P, Koliba P et al. Trimodal prehabilitation in oncogynaecology. Ceska Gynekol 2024; 89 (3): 224–228. doi: 10.48095/ cccg2024224.

3. Topinková E, Jurášková B, Hrkal J et al. Hodnocení disability s využitím nástroje WHODAS 2.0 u geriatrických pacientů. Pilotní studie WHODAS-GERI. Geri a Gero 2021; 10 (1): 3–11.

4. Leonardi M, Bickenbach J, Üstün TB et al. Definition of disability: what is in a name? Lancet 2006; 368 (9543): 1219–1221. doi: 10.1016/S0 140-6736 (06) 69498-1.

5. van der Graaff S, Backhuijs T, de Kort FP et al. Feasibility and effects of implementing multimodal prehabilitation before cytoreductive surgery in patients with ovarian cancer: the Gynofit multicenter study. Cancers (Basel) 2025; 17 (9): 1393. doi: 10.3390/cancers17091393.

6. Miralpeix E, Sole-Sedeno JM, Rodriguez-Cosmen C et al. Impact of prehabilitation during neoadjuvant chemotherapy and interval cytoreductive surgery on ovarian cancer patients: a pilot study. World J Surg Oncol 2022; 20 (1): 46. doi: 10.1186/s12957-022-02517-1.

7. Sládková P, Brtnický T, Hormandlová L et al. Ergoterapie v onkogynekologii: pilotní studie. Ceska Gynekol 2025; 90 (2): 113–121. doi: 10.48095/cccg2025113.

8. Lukaski HC. Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research. Eur J Clin Nutr 2013; 67 (Suppl 1): S2–S9. doi: 10.1038/ejcn. 2012.149.

9. Denovan A, Dagnall N. Using exploratory structural equation modelling to examine the psychometric properties of the 10-item Perceived Stress Scale. Curr Psychol 2025; 44 (13): 12863–12879. doi: 10.1007/s12144-025-08061-x.

10. Hollá M, Bartoš A. Krátké testy kognitivních funkcí do ordinace praktického lékaře. Prakt Lék 2019; 99 (5): 191–196.

11. Williams N. The borg Rating of Perceived Exertion (RPE) scale. Occup Med 2017; 67 (5): 404–405. doi: 10.1093/occmed/kqx063.

12. Rockwood K, Song X, MacKnight C et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173 (5): 489–495. doi: 10.1503/cmaj.050051.

13. Brorsson B, Hulter Asberg K. Katz index of independence in ADL. Reliability and validity in short-term care. Scand J Rehabil Med 1984; 16 (3): 125–132.

14. Ejupi A, Brodie M, Gschwind YJ et al. Kinect--based Five-Times-Sit-to-Stand Test for clinical and in-home assessmentof fall risk in older people. Gerontology 2016; 62 (1): 118–124. doi: 10.1159/000381804.

15. Li J, Yang X, Wang Y et al. Application of bioelectrical impedance analysis in the assessment of patients with gynecologic malignancies. J Nutr Oncol 2025; 6 (2): 67–74. doi: 10.1097/JN9.000000000000005.

ORCID autorů

P. Sládková 0000-0002-6726-8154

M. Tichá 0009-0003-3734-355X

M. Švábenická 0009-0000-6788-9340

K. Kotrbová 0009-0009-8479-3792

A. Šályová 0009-0003-5413-7213

Z. Vlastníková 0009-0001-9684-9353

M. Janatová 0000-0001-8485-2822

K. Hoidekrová 0000 0002 6981 5844

M. Polková 0009-0009-4581-1994

M. Zikán 0000-0001-5266-8895

T. Brtnický 0000-0002-6204-1903