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Identification and correction of modifiable risk factors, like malnourishment or anemia, in the preoperative assessment can improve surgical outcomes. All these factors in addition to poor preoperative physical performance correlate with increased complications and mortality risk after major surgery [2, 3, 12]. Figure 5.1 shows a preoperative algorithm, including some of the risk factors that should be evaluated. Assessment of preoperative functional capacity should be performed with CPET, if available, not only to identify those patients who may benefit from preoperative exercise training but also to prescribe the intensity of the program [14]. To get a good adherence to the exercise program, preferences and needs of patients have to be considered and led by a specialized physiotherapist. Some patients would require supervision in hospital rather than a home‐based program [2, 12]. Neoadjuvant therapies provide the opportunity to train patients before major cancer operations [10]. A recent systematic review supports the role of exercise training in patients undergoing neoadjuvant treatment [15]. Adherence rates were acceptable (66–96%), but the overall impact on HRQoL is still not known.