Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

PRIORITY-CONNECT SMS: an AI avatar-based model of perioperative support for gastrointestinal cancer surgery (146332)

Tiffany R Tsoukalas 1 2 , Kate Alexander 1 2 , Jack Reeves 2 3 4 , Zirong Bai 1 2 , Cherry Koh 1 2 5 6 , PRIORITY-CONNECT SMS Collaborative Group 7 , Daniel Steffens 1 2 5 8
  1. Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
  2. Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, NSW, Australia
  3. Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
  4. Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  5. Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW, Australia
  6. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  7. PRIORITY-CONNECT SMS Collaborative Group,
  8. NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia

Aims: Gastrointestinal cancers account for one-quarter of new cancer diagnoses and over one-third of cancer deaths globally. Despite advances in perioperative care, postoperative complications remain common, often leading to prolonged hospitalisation and delayed recovery. (P)rehabilitation has demonstrated efficacy in improving outcomes, yet access remains limited. England’s 2026 National Cancer Plan marks a significant policy shift, committing to universal, digital-first prehabilitation for all cancer patients. The Australian Cancer Plan doesn't specifically address prehabilitation, but more broadly prioritises co-designed, multidisciplinary and digitally enabled care across the cancer continuum. In this context, we evaluated the evidence for technology-enabled (p)rehabilitation and developed PRIORITY-CONNECT SMS, an AI-driven, avatar-based intervention providing timely, tailored, multidisciplinary pre- and post-surgical support for patients with gastrointestinal cancer, including those in under-served areas.

Methods: This program comprises three linked components: (i)a systematic review and meta-analysis of technology-enabled (p)rehabilitation in thoracic and abdominopelvic cancer surgery; (ii)co-design and development of PRIORITY-CONNECT SMS with patients, caregivers, clinicians and researchers, guided by Experience-Based Co-Design; and (iii)mixed-methods evaluation of acceptability and appropriateness, informing a subsequent randomised controlled trial.

Results: The review (17 RCTs; n=1690) found that technology-enabled (p)rehabilitation reduced length of stay by 1.33 days (95% CI 0.59–2.07),with improvements also reported in pain, depression, fatigue and distress. However, evidence was limited by modest sample sizes and intervention heterogeneity. Building on this evidence, >100 multidisciplinary avatar-based videos and accompanying patient information sheets have been developed and mapped to clinical timepoints, from diagnosis through survivorship. Content is informed by clinical guidelines, ERAS pathways, and Behaviour Change Wheel principles, with health-literacy review and iterative refinement ongoing.

Conclusions: Technology-enabled (p)rehabilitation shows promise as a scalable approach to perioperative care, particularly for patients with limited access to specialist services. PRIORITY-CONNECT SMS translates this evidence into a co-designed, digital model, with the aim of extending equitable, multidisciplinary support across the surgical pathway.