247 The role of a prehabilitation service in improving lung cancer resection rates in a high-risk surgical cohort

Abstract

Introduction Prehabilitation (Pre-hab) in lung cancer aims to optimise patient's cardiorespiratory fitness to facilitate high-risk patients undergo curative lung cancer surgery with lower risk of complications. BTS guidelines on the Radical Management of Lung Cancer state that risk stratification for death in thoracic surgery remains relatively rudimentary. Lung function (including DLCO) and Performance Status (PS) are important aspects of this risk assessment. Methods We retrospectively reviewed high-risk patients who underwent Pre-hab for lung cancer between October 2022 and August 2024 in our NHS Trust. The Pre-hab service is based in a large teaching hospital within East London. We looked at a cohort of 'high-risk' patients divided into two groups; patients who had a) DLCO=2 (and DLCO>50%). We assessed the proportion of patients who proceeded to lung cancer resection surgery after completing Prehab and evaluated the outcomes. Outcomes included length of Pre-hab (from first appointment to date of surgery), length of hospital stay (LOS), and post-operative complications using the Clavien-Dindo classification (POC grade 1-5). Results 176 patients were referred for Pre-hab.105 patients were low-risk. 34 patients had a DLCO=2 (and DLCO>50%). Outcomes are displayed in figure 1. Figure 1 (see attachment). Conclusion We have shown that Pre-hab is feasible at scale in a large surgical cohort within a deprived area of the UK, with high rates of patients proceeding to surgery, short hospital stays and low complication rates. Disclosure No significant relationships. [Formula presented]