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Colorectal CancercrEATeNCT07922850

Tailored Nutrition vs. Exercise Prehabilitation Before Colorectal Cancer Surgery

A study testing Tailored Nutritional Counselling and Physiotherapist-Guided Exercise Programme in people with Colorectal Cancer and Colorectal Neoplasms, run by University Hospital of North Norway at 2 sites in Norway.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study will test whether tailored nutritional support before surgery, alone or combined with a structured exercise program, can help adult patients recover better after surgery for colorectal (bowel) cancer. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Colorectal Cancer, Colorectal Neoplasms
What is being tested?
Tailored Nutritional Counselling and Physiotherapist-Guided Exercise Programme
Could I receive a placebo?
No, everyone receives an active treatment
How many people
140 participants
Where
2 sitesNorway
Study dates
1 Dec 2026to Aug 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients undergoing elective colorectal cancer surgery who give informed consent and meet all of the following will be eligible:
  • Planned elective surgery for colorectal cancer
  • Age >=18 years
  • If neoadjuvant treatment has been given, treatment must be completed and the patient must be scheduled for surgery
  • Able to understand Norwegian sufficiently to receive study information, complete questionnaires, and follow written and oral instructions
  • Able and willing to provide written informed consent

Who cannot join

  • Known metastatic disease
  • Previous participation in structured multimodal prehabilitation as part of the current cancer treatment pathway before inclusion, for example during neoadjuvant therapy
  • Previous major gastrointestinal surgery considered by the treating clinician to substantially affect the planned colorectal cancer surgery or postoperative recovery
  • Physical impairment that prevents the participant from walking for six minutes or rising independently from a chair
  • Planned multivisceral resection and/or complex reconstruction due to locally advanced cancer
  • Ongoing severe nutritional support, such as parenteral nutrition, that limits the feasibility of the allocated intervention
Show all 11Show fewer
  • Cognitive impairment that prevents the participant from understanding the intervention, exercise programme, questionnaires, or written and oral instructions
  • Severe comorbidity or other medical condition that, in the judgement of the treating clinician, precludes participation in structured exercise
  • Severe renal failure, including patients requiring dialysis or with clinically significant electrolyte disturbances
  • Inability to use the telemedicine technology required for follow-up when telemedicine-based follow-up is planned
  • No permanent address or expected hospital/institutional stay for more than 50% of the time between diagnosis and planned surgery

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Martin Iversen Hagve, MD, PhD contact

+4777626447

martin.iversen.hagve@unn.no

Norway2 sites
  • Nordland Hospital Trust

    Bodø

    Kåre Nordland, Kare.Ragnar.Nordland@nordlandssykehuset.no

    Martin Iversen Hagve, +4777626447, martin.iversen.hagve@unn.no

  • University Hospital of North Norway

    Tromsø

    Martin Iversen Hagve, +4777626447, martin.iversen.hagve@unn.no

Other trials in Norway

About this study

Official title: ColoREctal Cancer Surgery and Multimodal pREhabilitation Assessing Tailored Nutrition vs. Exercise - An Open Label Superiority Multicenter Randomized Controlled Trial.

This study will test whether tailored nutritional support before surgery, alone or combined with a structured exercise program, can help adult patients recover better after surgery for colorectal (bowel) cancer. Participants will be randomly assigned to one of three groups: usual care, tailored nutritional support alone, or nutritional support combined with a structured exercise program (multimodal prehabilitation). The main goal is to find out whether either approach improves physical function 30 days after surgery, measured by how far participants can walk in 6 minutes (the 6-minute walk test). The study will also look at nutritional intake, physical function, quality of life, complications, hospital readmissions, and length of hospital stay. A total of 140 adult patients scheduled for surgery for colorectal cancer at hospitals in Northern Norway will be enrolled.

Read the detailed description

Hypothesis: Tailored preoperative nutritional therapy in a regular clinical setting improves postoperative functional capacity, and while nutritional intervention alone may improve surgical outcome, multimodal prehabilitation combining nutrition and exercise provides additional benefit, particularly improvement in physical function.

Design: This is a three-armed, open-label, multicentre, parallel-group randomized controlled superiority trial comparing standard of care, tailored nutritional intervention alone, and multimodal prehabilitation (nutrition plus structured exercise) in patients undergoing elective colorectal cancer surgery. Participants are allocated 1:1:1 using a computer-generated randomization sequence with randomly permuted block sizes, stratified by study site, nutritional risk (NRS-2002) and clinical frailty score. Data are collected at three time points: baseline (first surgical consultation), after completion of the preoperative intervention (preferably the day before surgery), and approximately 30 days after surgery.

Interventions: The nutrition intervention consists of individualised dietary counselling from a clinical dietitian, targeting a protein intake of 1.2-1.5 g/kg/day, supplemented as needed with oral nutritional supplements. The multimodal prehabilitation intervention adds a structured, physiotherapist-guided home exercise programme (aerobic and resistance training, 3 times weekly) to the nutrition intervention. The intervention period reflects the normal clinical waiting time to surgery, limited to a minimum of 2 and a maximum of 5 weeks.

Sample size: Based on pilot data and power calculations from the dHOPE study in the same patient population, using a standard deviation for change in 6-minute walk test of 43 metres, alpha=0.05 and 80% power, 40 evaluable patients per group are needed. Allowing for an estimated 15% combined screen failure and dropout, a total of 140 patients will be enrolled.

Statistics: Analyses will follow the intention-to-treat principle. The primary endpoint will be analysed using a linear mixed-effects model including treatment group, time and the group-by-time interaction, adjusted for baseline 6-minute walk test and the stratification variables. Continuous secondary outcomes will be analysed with similar mixed models; binary outcomes with logistic regression.

Retrospective substudy: A separate substudy will assess body composition and nutritional status retrospectively, based on routinely acquired preoperative abdominal CT scans and available clinical data, in order to calculate whether participants meet the Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition and to explore associations between body composition, nutritional status, functional reserve, and postoperative outcomes. No additional CT scans are performed for study purposes, and results do not influence clinical treatment during the study.

Being tested
Tailored Nutritional Counselling, Physiotherapist-Guided Exercise Programme
Keywords
Prehabilitation, Nutritional Support, Exercise
Medical subject headings
Colorectal Neoplasms, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tailored Nutritional CounsellingBehavioural

    Individualised dietary counselling delivered by a clinical dietitian, beginning with a baseline nutritional assessment. Target protein intake is set at 1.2-1.5 g/kg/day, with oral nutritional supplements or protein powder used when dietary intake alone is insufficient. Includes weekly follow-up with weight measurement and adjustment of nutritional advice from inclusion until 30 days postoperatively.

  • Physiotherapist-Guided Exercise ProgrammeBehavioural

    Structured, physiotherapist-guided exercise programme combining aerobic and resistance training three times per week, with intensity individually adjusted using the Borg scale. Participants keep an exercise diary and receive weekly follow-up from a physiotherapist from inclusion until 30 days postoperatively.

Study groups in NCT07922850
Study groupRoleWhat they receive
Standard of CareNo interventionParticipants receive standard of care: routine preoperative and perioperative management according to local hospital procedures and current national guidelines. No study-specific nutritional or exercise intervention is provided in this arm.
Tailored Nutritional InterventionExperimentalParticipants receive a structured nutritional intervention led by a clinical dietitian, targeting a protein intake of 1.2-1.5 g/kg/day through individualised dietary counselling, oral nutritional supplements or protein powder when needed, and enteral/parenteral nutrition when clinically indicated, per ESPEN guidelines. Weekly dietitian follow-up is provided from inclusion until 30 days postoperatively. No structured exercise programme is provided in this arm.
Receives: Behavioral: Tailored Nutritional Counselling
Multimodal PrehabilitationExperimentalParticipants receive the same tailored nutritional intervention as the Tailored Nutritional Intervention arm, combined with an individualised, physiotherapist-guided exercise programme comprising moderate-intensity aerobic exercise and resistance training three times weekly. Participants keep an exercise diary and receive weekly physiotherapist follow-up from inclusion until 30 days postoperatively, alongside the dietitian-led nutritional follow-up.
Receives: Behavioral: Tailored Nutritional Counselling; Behavioral: Physiotherapist-Guided Exercise Programme

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in 6-Minute Walk Test Distance

    Distance walked (in metres) during a standardised 6-minute walk test, a validated measure of functional exercise capacity.

    Measured: Baseline and 30 days after surgery

Secondary outcomes (11)
  1. Change in Handgrip Strength

    Maximal isometric handgrip strength measured in kilograms using a hand dynamometer, as an indicator of muscle strength.

    Measured: Baseline and 30 days after surgery

  2. Change in 30-Second Chair Stand Test (30s-CST)

    Lower-extremity muscle strength and endurance assessed using the 30-Second Chair Stand Test (30s-CST): the number of complete sit-to-stand repetitions performed in 30 seconds from a standard-height chair without armrests, with arms crossed over the chest. The score is a count of repetitions with a minimum value of 0 and no fixed maximum; higher values indicate better lower-extremity physical function. Results can be compared with published age- and sex-specific reference values.

    Measured: Baseline and 30 days after surgery

  3. Change in Nutritional Intake

    Daily energy (kcal/kg/day) and protein (g/kg/day) intake, assessed using dietary records or recall.

    Measured: Baseline, end of preoperative intervention period (up to 5 weeks), and 30 days after surgery

  4. 30-Day Hospital Readmission Rate

    Proportion of participants readmitted to hospital within 30 days after surgery.

    Measured: Within 30 days after surgery

  5. Rate of Severe Postoperative Complications

    Proportion of participants experiencing severe postoperative complications. Complications are classified using the Clavien-Dindo classification, which grades postoperative complications from Grade I (any deviation from normal recovery not requiring specific treatment) to Grade V (death); severe complications are defined as Grade IIIb or higher, i.e. complications requiring intervention under general anesthesia, or life-threatening complications (including organ dysfunction) requiring intensive/critical care management.

    Measured: Within 30 days after surgery

  6. Length of Hospital Stay

    Total number of days from date of surgery to date of hospital discharge.

    Measured: From date of surgery to date of hospital discharge, up to 30 days

  7. Change in Nutritional Risk Screening (NRS-2002) Score

    Nutritional risk assessed using the Nutritional Risk Screening 2002 (NRS-2002) tool, ranging from a minimum value of 0 and a maximum value of 7. A score of 3 or more indicates the patient is nutritionally at-risk and a nutritional care plan should be initiated; a score below 3 indicates the patient is not currently at nutritional risk.

    Measured: Baseline and end of preoperative intervention period (up to 5 weeks)

  8. Change in Clinical Frailty Scale Score

    Frailty status assessed using the Clinical Frailty Scale (CFS), a 9-point judgement-based scale ranging from a minimum value of 1 and a maximum value of 9. A score of 1 indicates a very fit patient, and a score of 9 indicates a terminally ill patient; higher scores indicate increasing frailty, with a score of 5 or above generally considered indicative of clinically significant frailty.

    Measured: Baseline and end of preoperative intervention period (up to 5 weeks)

  9. Change in Health-Related Quality of Life (EQ-5D-5L)

    Health-related quality of life measured using the EQ-5D-5L questionnaire. The descriptive system covers 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each scored from a minimum value of 1 (no problems) to a maximum value of 5 (extreme problems/unable), which can be combined into a single index value. The EQ Visual Analogue Scale (EQ VAS) records self-rated overall health from a minimum value of 0 (the worst health you can imagine) to a maximum value of 100 (the best health you can imagine).

    Measured: Baseline and 30 days after surgery

  10. Postoperative Quality of Recovery (QoR-15)

    Postoperative recovery quality assessed using the 15-item Quality of Recovery score (QoR-15), ranging from a minimum value of 0 and a maximum value of 150. Higher scores indicate better quality of postoperative recovery.

    Measured: Baseline and 30 days after surgery

  11. Change in Cancer-Specific Quality of Life (EORTC QLQ-C30)

    Cancer-specific health-related quality of life measured using the EORTC QLQ-C30 questionnaire. Raw scores for each functional scale, symptom scale, and the global health status/QoL scale are linearly transformed to a minimum value of 0 and a maximum value of 100. Higher scores on the functional scales and the global health status/QoL scale indicate better functioning/quality of life, whereas higher scores on the symptom scales indicate greater symptom burden.

    Measured: Baseline and 30 days after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Nov 2026
  2. Study start1 Dec 2026 (estimated)
  3. Primary completionAug 2028 (estimated)
  4. Study completionAug 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
140 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07922850
Sponsor's protocol ID
1001278
Acronym
crEATe
Status last verified
Nov 2026
First submitted
2 Nov 2026
Last updated
6 Nov 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: IPD will not be shared due to patient confidentiality. Parts of the data set may be available on reasonable request.

Questions about this trial

What is this clinical trial studying?

A study testing Tailored Nutritional Counselling and Physiotherapist-Guided Exercise Programme in people with Colorectal Cancer and Colorectal Neoplasms, run by University Hospital of North Norway at 2 sites in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 6 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Martin Iversen Hagve, MD, PhD (+4777626447, martin.iversen.hagve@unn.no), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in 6-Minute Walk Test Distance (time frame: Baseline and 30 days after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Nov 2026.

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