Perioperative Implications of Neoadjuvant Therapies and Optimization Strategies for Cancer Surgery

Patients with cancer having either cancer- or non-cancer-related surgery present to the perioperative clinician with a unique set of challenges. Adequate assessment, risk stratification, and optimization of these patients requires the perioperative physician to be familiar with the natural history of the cancer, the systemic effects of the malignant disease on the body, and also the effects of neoadjuvant treatments on the major organ systems. Deconditioning is a multisystem disorder that is related to cancer treatments, sedentary lifestyle, and the malignant disease itself. It is being increasingly recognized as condition that is amenable to reversal with appropriate “prehabilitation” strategies. This article will give the reader an overview of the perioperative issues and optimization strategies for patients awaiting cancer surgery.