Preoperative Exercise to Improve Fitness in Patients Undergoing Complex Surgery for Cancer of the Lung or Esophagus (PRE-HIIT): A Randomized Controlled Trial

This PRE-HIIT randomized controlled trial published in the Annals of Surgery evaluated whether a brief, high-intensity interval training (HIIT) program could improve preoperative cardiopulmonary fitness in patients awaiting complex surgery for lung or esophageal cancer. Seventy-nine patients scheduled for curative resection were randomized to either HIIT (five days per week of 30-minute cycling intervals) or standard care with moderate exercise. At baseline, most patients had very poor fitness. After the intervention, those in the HIIT group experienced a significant increase in peak oxygen consumption (VO₂peak) compared to the standard care, with a 6.6 percent between-group difference, while the standard care group showed minimal change. Additionally, lower limb functional performance, measured by sit-to-stand scores, improved significantly with HIIT. These results demonstrate that targeted prehabilitation can produce meaningful physiological gains within short preoperative windows in deconditioned patients. This study is important to the cardiothoracic surgery community and CTSNet’s global audience because improved cardiorespiratory fitness before resection may translate into lower perioperative risk and better recovery, especially in high-risk thoracic oncology patients where baseline fitness often predicts postoperative outcomes.