Whole Course Multi-model Prehabilitation to Improve Clinical Outcome in Patients Undergoing Neoadjuvant Treatment Prior to Gastrectomy

Inclusion criteria

• Aged ≥18 years;
• Eastern Cooperative Oncology Group (ECOG) performance status score ≤2；
• Endoscopic biopsies were pathologically confirmed as gastric adenocarcinoma；
• The feasibility of neoadjuvant therapy was suggested by MDT, and the feasibility of radical gastrectomy was re-evaluated after neoadjuvant therapy;
• Blood routine, liver function, kidney function, heart function and lung function were normal before neoadjuvant therapy, and there was no contraindication of chemotherapy and surgery;
• The pregnancy test was negative within 1 month, and she was not pregnant or breastfeeding;
• Informed consent and ability to comply with research protocols.

Exclusion criteria

• metastasis;
• End-stage cardiac insufficiency (LVEF<30% or NYHA class IV), liver cirrhosis (Child-Pugh classification C), End-stage renal failure (receives chronic dialysis), or ASA grade IV;
• Cerebral hemorrhage, cerebral infarction, TIA or central nervous system disease or mental illness within 6 months, could not cooperate with the completion of neoadjuvant therapy and pre-rehabilitation exercise;
• Patients have severe infections (such as MODS, etc.) or have allergic reactions to chemotherapy drugs and metabolic disorders;
• Concurrent tumors or other diseases requiring simultaneous surgery (except laparoscopic gallbladder surgery);
• Emergency surgery is required due to tumor complications (e.g., bleeding, perforation, obstruction);
• Patients participating in other clinical trials.