PILOTING A PREHABILITATION PROGRAM TO IMPROVE PERFORMANCE STATUS AMONG PATIENTS WITH LIVER CANCER IN TANZANIA jeaninejustiniano@gmail.com

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PILOTING A PREHABILITATION PROGRAM TO IMPROVE PERFORMANCE STATUS AMONG PATIENTS WITH LIVER CANCER IN TANZANIA

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United States

Oral or Poster

Liver cancer is the third leading cause of cancer-related mortality worldwide, with nearly 80% occurring in LMICs. Prehabilitation programs are well established in HICs to improve patient’s performance status, surgical candidacy, and perioperative outcomes. Despite the demonstrated low cost, prehabilitation programs have not been widely utilized in LMICs. We designed a prehabilitation program to evaluate feasibility and impact on treatment outcomes. We piloted this program at Muhimbili National Hospital (MNH) in Tanzania.

This was a 6-week pilot interventional study involving patients with liver cancer and an ECOG >1 completing daily exercises and nutritional goals.

Seven participants enrolled in 5 months. Median age was 48 (range 34 - 63) and 57% (4) were male. Median ECOG was 2 (range 1 - 2). Barriers encountered: inadherence to weekly goals (100%), loss to follow up due to lack of transportation (43%) or inability to communicate via telephone (43%), clinical deterioration (71%), pain limitations (57%), and economic hardships (14%). Four participants died within the 6 weeks. Two participants died shortly after the program. None were deemed surgical candidates initially nor after program completion. None had improvement in their performance status.

This piloted study demonstrated barriers to program adherence, including exercise log completion, dietary protein intake, and patient follow up. This was further impacted by a discordance of ECOG/BCLC stage prognosis and observed survival, highlighting the need for SSA context-specific HCC guidelines. Future efforts are needed to address barriers to early diagnosis and treatment among patients with liver cancer in low- and middle- income countries.