Multimodal prehabilitation significantly reduces postoperative complications in esophago-gastric cancer surgery, highlighting its importance in surgical care.

• Respiratory complications fell from 43.8% to 20.9% with prehabilitation (p=0.010).
• Cardiac issues decreased from 22.3% to 7.0% (p=0.037), and hepatic and renal complications were eliminated in the prehabilitation cohort.

Integrating prehabilitation can improve patient selection and optimize outcomes.

• Hospital stays were shorter (14 days vs. 11 days, p<0.001), and chemotherapy rates increased from 51% to 80.6% (p=0.004).