Exercise Training During Neoadjuvant Treatment for Gastroesophageal Cancer and Tumor Surgery: A Randomized Clinical Trial

Importance: Physical deterioration and disease progression during neoadjuvant treatment can preclude tumor surgery in patients with gastroesophageal cancer. Whether preoperative exercise training can increase the probability of undergoing tumor surgery remains unknown.

Objective

To compare exercise training with usual care on the likelihood of not undergoing tumor surgery with curative intent after neoadjuvant treatment for gastroesophageal cancer. Design, setting, and participants: PRESET-RCT was a single-blinded, parallel-group, 2-arm, superiority randomized clinical trial. Patients with gastroesophageal adenocarcinoma scheduled to undergo treatment with curative intent, including neoadjuvant treatment, and with no contraindication to exercise training were eligible. Participants were enrolled at University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark, from August 16, 2018, to September 23, 2022, with final follow-up on October 22, 2024. Data analysis was performed from March 2023 to May 2025.