Effect of Preoperative Nutritional and Exercise Intervention in Older Frail Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

Background Frailty is related with poor surgical outcomes in several types of cancer. This study aimed to investigate the importance of preoperative intervention with nutrition and exercise for older frail patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Methods Older frail patients who underwent upfront hepatectomy for HCC at our institution between April 2007 and August 2024 were retrospectively reviewed. Clinicopathological factors were compared between the intervention and non-intervention groups. Results In 51 older patients with frailty, the postoperative hospital stay was significantly shorter in the intervention group than in the non-intervention group. The neutrophil-to-lymphocyte ratio was significantly decreased after the intervention compared with before the intervention (p < 0.01). When the postoperative hospital stay was analyzed according to the severity of frailty, the postoperative hospital stay was significantly shorter in the intervention group than in the non-intervention group (15 vs. 20 days, p = 0.02). The long-term outcome was not significantly different between intervention and non-intervention groups. Conclusions Preoperative intervention with nutrition and exercise may be associated with improved short-term outcomes in older frail patients with HCC who undergo hepatectomy.