Prehabilitation in Adults Undergoing Cancer Surgery: A Comprehensive Review on Rationale, Methodology, and Measures of Effectiveness

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The article reports a narrative review on prehabilitation before cancer surgery. The topic is interesting, and the article is well organized, educationally useful, and a good summary of current knowledge.

I have only few methodological suggestions:

- lines 61-62: "our aim was to perform a comprehensive narrative review behind the rationale, methodology, and measures of effectiveness of prehabilitation in patients undergoing cancer surgery". I suggest that this could be the goal (or whatever other word you prefer for "what we did") and that the goal (or aim) is "why we did it." Who is the target audience for this article? The surgeons? The researchers? Both?

- lines 64-67: Although this is a narrative (hence non-systematic) review, you should give more details for the reader. How many articles did you retrieve and examine? What are the time limits? I noticed that there are no article beyond 2023, but a quick search I did in PubMed found eight systematic reviews-metanalyses. The reader should be aware of the most recent literature you have considered, even in considering that at line 421 you wrote "In this manuscript, we have performed an updated review"

- methods to enforce thrustworthiness: a major problem with narrative and non-systematic reviews is "berry-picking."  What strategy have you adopted to avoid the "berry-picking" effect (i.e. you already had an idea of what to write and looked for the articles supporting you view) and let the retrieved data express the meaning? How did you select the articles, among all the retrieved ones? Discussion among authors? Recursive coding of the selected articles? Other?

- line 72 and related paragraph from line 367 on: I'm not fully confortable with the expression "What is the minimum effective duration...". This is a quantitative question, and only a meta-analysis could give a pertinent answer. I suggest adding "suggested", like "What is the suggested minimum effective duration..."

- Consider adding subsections, as you did in paragraph 3. They might help the reader flow through the text more easily.

- In Discussion, add a section about the limitation of your review

Author Response

Please see attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Well written work outlining the importance and rationale of prehabilitation in cancer surgery.

One minor suggestion is that the authors should attempt to make reference to prehabilitation in  chronic disease non cancer patients a good example being orthopaedic surgery. The authors make consider the concept of prehabilitation for all patients which is then targeted to those at greatest risk  perhaps using AI algorithms to automatically screen and triage. As the population ages this concept will become more important overall for all surgery and perhaps the concept of prehabilitation screening being a routine for all planned surgery much the same as perinatal classes for pregnant women

Author Response

Please see attachment

Author Response File: Author Response.pdf