Prehabilitation in Gynaecological Cancer Patients (PHOCUS)

  • End date
    Jun 30, 2026
  • participants needed
  • sponsor
    Charles University, Czech Republic
Updated on 20 April 2022
hormone therapy
cancer chemotherapy
ovarian cancer
tumor debulking
ovarian epithelial carcinoma
cancer of the ovary
epithelial ovarian cancer
primary debulking surgery
interval debulking surgery


Prehabilitation refers to interventions aiming to improve patients' resilience and functional capacity before a known stressful event, e.g., scheduled surgery. These interventions usually consist of physical activity and psychological and nutritional support. There is substantial evidence of the positive effect of multimodal prehabilitation among patients treated surgically for non-gynaecological cancers; however, no prospective data are available in gynaecological cancer patients.

PHOCUS trial is a prospective randomised trial aiming to evaluate the role of multimodal prehabilitation in patients with gynaecological cancer. Sixty-four patients will be randomised in single institution within 36 months with a 1:1 ratio into ARM A: control arm which will be provided with a basic information and standard of care support; ARM B: active arm undergoing multimodal prehabilitation composed of physical activity and psychological and nutritional support. All patients will be assessed at standard intervals (three times during the trial) by a spectrum of non-invasive tests, evaluating physical functional capacity, postoperative morbidity, nutritional status, level of stress and anxiety, and quality of life.


The objective of the trial is to evaluate the impact of intensive multimodal prehabilitation protocol on pre-operative functional capacity, postoperative morbidity, and quality of life in patients undergoing surgical treatment for gynaecological cancer.

Two groups of patients scheduled for postponed surgical treatment will be eligible for the trial: i) advanced ovarian cancer patients referred for neoadjuvant chemotherapy and interval debulking surgery; ii) stage I-II endometrial cancer patients classifying as frail (according to the validated modified Frailty Index), who will be treated by hormonal therapy for three months, followed by surgical treatment.

Condition Ovarian Cancer, Ovarian Cancer Stage III, Ovarian Cancer Stage IV, Endometrial Cancer, Frailty
Treatment psychological intervention, nutritional intervention, Physiological intervention
Clinical Study IdentifierNCT04789694
SponsorCharles University, Czech Republic
Last Modified on20 April 2022


Yes No Not Sure

Inclusion Criteria

Two groups of patients will be eligible for the trial
i) Epithelial ovarian cancer patients referred for NACT: a) FIGO stage III or IV disease
b) Patient is not a candidate for primary debulking surgery; c) Patient is a suitable
candidate for standard of care combined chemotherapy; d) Patient is a candidate for
interval.debulking surgery
ii) Stage I or II endometrial cancer patients classifying as frail according to the
validated modified Frailty Index: a) FIGO stage I or II; b) Patient is classified as frail
c) Patient is suitable candidate for hormonal therapy

Exclusion Criteria

Second malignant tumour (under the treatment)
Patient is not suitable for any surgery delay
Patient is not physically able to meet the prehabilitation intervention plan or is
unable to walk
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