Background: The potential benefits of prehabilitation in patients undergoing surgery for renal cell carcinoma (RCC) or upper-tract urothelial carcinoma (UTUC) remain unknown. The aim was to evaluate physical function and baseline characteristics over the course of treatment to identify a potential need for prehabilitation. Methods: In this prospective observational study, 62 patients were enrolled—31 undergoing nephrectomies for RCC and 31 undergoing nephroureterectomy for UTUC. Baseline assessments included nutritional screening (NRS 2002), frailty (Clinical Frailty Scale), hemoglobin and iron levels, smoking status, and physical function using the Six-Minute Walk Test (6MWT) and the 30-Second Sit-to-Stand Test (30STS). Functional tests were repeated at hospital discharge and at two-week postoperative follow-up visit. Results: At baseline, 45% of RCC and 68% of UTUC patients were at nutritional risk. Preoperative frailty was present in 20% of the cohort, and 53% had anemia. Functional impairment below the lower limit values (LLVs) was observed in 16% for the RCC and 36% of the UTUC, assessed by 6MWT. The 30 STS revealed that 58% of RCC and 42% of UTUC were below LLV. At discharge, impairment peaked, with 59% and 82% of patients being below the LLVs, respectively. Functional performance partially recovered at follow-up but did not return to baseline levels. Conclusions: Preoperative nutritional deficits, anemia, and functional impairment are prevalent in patients undergoing nephrectomy or nephroureterectomy. A marked postoperative functional decline was identified postoperatively supporting a potential need for early individualized prehabilitation strategies to improve recovery in patients undergoing kidney cancer surgery.
背景：对于接受肾细胞癌（RCC）或上尿路尿路上皮癌（UTUC）手术的患者，预康复的潜在益处尚不明确。本研究旨在评估治疗过程中患者身体功能与基线特征，以明确预康复干预的必要性。方法：在这项前瞻性观察性研究中，共纳入62例患者，其中31例因RCC接受肾切除术，31例因UTUC接受肾输尿管切除术。基线评估包括营养筛查（NRS 2002量表）、衰弱程度（临床衰弱量表）、血红蛋白与铁水平、吸烟状况，以及通过六分钟步行试验（6MWT）和30秒坐站试验（30STS）评估的身体功能。功能测试在患者出院时及术后两周随访时重复进行。结果：基线评估显示，45%的RCC患者和68%的UTUC患者存在营养风险；20%的患者术前存在衰弱状态；53%的患者患有贫血。通过6MWT评估，16%的RCC患者和36%的UTUC患者身体功能低于正常值下限；30STS测试显示，58%的RCC患者和42%的UTUC患者功能值低于正常下限。出院时功能损伤达到峰值，分别有59%和82%的患者功能低于正常下限。随访时功能部分恢复，但未恢复至基线水平。结论：接受肾切除术或肾输尿管切除术的患者普遍存在术前营养不足、贫血及功能损伤。术后患者身体功能显著下降，这提示有必要实施早期个体化预康复策略，以改善肾癌手术患者的康复效果。
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