Introduction: Soft tissue sarcomas (STS) are rare, malignant tumors mainly found in the extremities and trunk. Treatment of STS includes salvage surgery and possibly chemotherapy and/or radiation. Despite treatment advances, patients may experience side effects including functional decline, fatigue, and reduced quality of life. In other cancers, prehabilitation (preoperative exercise and diet interventions) has been associated with increased postoperative physical function, enhanced recovery, and increased quality of life; however, prehabilitation in STS patients remains understudied. This study assessed STS patients’ needs and preferences for lifestyle prehabilitation programs.

Methods: STS patients completed an online questionnaire including cancer and treatment history and current physical activity and diet. They also participated in a semi-structured interview including questions about their treatment and symptoms, lifestyle behaviors, and feedback and preferences for prehabilitation physical activity and nutrition programming. Data from interviews were analyzed by 5 research team members using an inductive approach through thematic text analysis.

Results: Participants (N = 20) were 50% female, ages 22 to 77 years. Patients who received chemotherapy before surgery (83%) felt fatigue and loss of appetite. Patients who received radiation (63%) felt fatigue and loss of physical function. Five themes emerged from the interviews for patients’ needs and preferences towards prehabilitation: (1) Prehabilitation lifestyle resources to allow ownership over recovery; (2) Consistent reinforcement and feedback; (3) Tracking external factors that influence lifestyle habits; (4) Social support from other STS survivors; and (5) Remote access to support and resources.

Discussion: Participants emphasized the need for prehabilitation resources like physical activity and nutrition recommendations before surgery, as early access would empower them to take ownership of their recovery. They expressed interest in regular reinforcement and utilizing tools like wearables or apps. Participants suggested future lifestyle interventions should consider external factors like mental health, symptoms, side effects, and family stressors when designing programs. Lastly, support from other STS survivors was seen as valuable for accountability and encouragement. Overall, participants viewed a prehabilitation program as beneficial to improve postoperative outcomes and quality of life.