Abstract / Summary
Both cancer and complications of major cancer surgery can induce sarcopenia, nutritional disorders, and physical deconditioning by prolonged bed rest during hospital stays. Although recommendations on rehabilitation advocate early postoperative mobilization, the hospital environment is not often conducive to walking safely. A previous pilot study showed that supervised sessions on walking treadmill in older cancer inpatients were feasible and could improve gait speed, provided they were not malnourished. This study aims to assess the effectiveness of daily sessions on a walking treadmill in improving recovery of preoperative gait speed by the time of discharge from hospital, following elective cancer surgery in older patients. The APPAHOCA-2 study is a prospective, multicenter, open-label phase II trial. It will enroll 60 patients aged 65 years and older before elective major and/or estimated high-morbidity oncological surgery from two French centers. The main endpoint is the proportion of patients who will recover their preoperative functional fitness upon discharge from the surgical ward, measured by the 6-min Walk Test (6MWT). Baseline assessment of the 6MWT is collected during a comprehensive geriatric assessment visit within the month prior to the surgical procedure. Unless there are medical contraindications, enrolled patients will be offered one to two daily sessions of walking on a treadmill, under the supervision of an Adapted Physical Activity Specialist (APAS), starting the day after surgery, with a target duration of between 6 and 30 min. Various parameters will be collected preoperatively, at hospital discharge, and at the same time as routine surgical visits, at 30 days and 90 days postoperatively. Assessments include levels of anxiety and depression, concerns about falling, cognitive functions, nutritional and sarcopenia status, sleep complaints and sleep/wake modifications, and daytime activity, physical performances and blood exams. This study will examine the impact of early supervised walking sessions offered to older patients after elective oncological surgery throughout their hospital stay. It will explore the level of effectiveness of the intervention with regard to the number and duration of walking sessions carried out by patients in recovery. ClinicalTrial.gov identifier NCT06201884 (registered 2 January 2024). Version 4.1 dated from December 18, 2025.