REcovery After Cancer Application (RECapp)

REcovery After Cancer Application (RECapp) - Personalised Support After Surgery for Oesophageal and Gastric Cancer Patients

The RECapp study is a clinical trial evaluating a digital tool designed to support patients recovering from surgery for oesophageal or stomach cancer. The goal is to reduce symptoms and improve quality of life during recovery.

Each year in Sweden, around 1,400 people are diagnosed with these cancers. Although more people are surviving thanks to better treatments, recovery after surgery is often long and challenging, with lasting physical and emotional effects. At the same time, healthcare systems are under pressure to provide long-term support.

RECapp is a digital platform developed together with patients and healthcare professionals. It includes a mobile app for patients and a web portal for healthcare staff. Patients can track their symptoms, receive personalised self-care advice, and get guidance on when to contact healthcare. Healthcare providers can follow patients' progress remotely.

In this study, 250 patients from across Sweden will take part. They will be randomly assigned to either standard care or standard care plus RECapp. Participants will be followed for six months after surgery, and their symptoms and quality of life will be regularly assessed through questionnaires.

If RECapp proves effective, it could become part of future cancer care in Sweden-helping patients feel better supported while also making care more efficient.

Study Overview

• Status: Not yet recruiting
• Conditions: Oesophageal Cancer; Gastric Cancer (Diagnosis)
• Intervention / Treatment: Device: The RECapp platform

Detailed Description

The overall aim of the clinical trial is to evaluate the digital RECapp-platform, intended to reduce symptom burden and improve quality of life for patients who have undergone surgery with curative intent for oesophageal or gastric cancer.

In Sweden, approximately 1,400 patients, predominantly older men, are diagnosed with oesophageal or gastric cancer each year. Despite the poor prognosis of these cancer diagnoses, the number of survivors is increasing due to improved treatment options. When a curative approach is pursued, extensive, resectional surgery is usually performed, often in combination with oncological treatment. After surgery, recovery can be long, difficult, and incomplete, with reduced quality of life on a physical, psychological, and social level.

Cancer care providers and healthcare systems are challenged in meeting the growing needs of the rising number of patients surviving cancer. Furthermore, traditional long-term follow-up care involving routine hospital visits is being questioned for its effectiveness and the anxiety it may cause. There is a growing interest in patient-initiated and technology-assisted follow-ups using mobile applications to enhance autonomy, improve recovery, and reduce pressure on healthcare systems.

The Surgical Care Science research group has through multiprofessional collaborations and patient involvement developed the RECapp platform, consisting of a mobile app for patients and a web-based care portal for healthcare providers. The platform helps patients self-monitor their symptoms, provides personalised feedback, and recommends actions based on the symptoms reported. The RECapp platform allows patients to access their data through the RECapp app, while healthcare providers can review patient data in the RECapp care portal. The ambition has been to develop a digital platform to reduce symptom burden and increase patient autonomy in managing symptoms during the post-surgery recovery process, but also improve communication between patients and healthcare providers and optimise healthcare resource use by minimising unnecessary appointments and contacts.

The trial aims to test the RECapp-platform in a national randomised controlled trial, where 250 patients will be randomly assigned to either an intervention group (standard care + RECapp) or a control group (standard care only). Each research participant will be included in the study prior to surgery, and followed up for six months from hospital discharge post-surgery when the intervention is initiated. Both groups will be regularly assessed through validated questionnaires. The primary outcome is symptom burden at three months, and several secondary outcomes will be assessed at both three and six months. Sweden's seven university hospitals will be invited to participate in the clinical trial. Close relatives will be invited through participating patients, to respond to questionnaires about their experience as a close relative to these patients.

If the RECapp platform is shown to have positive effects on patients' symptom burden and thus their health-related quality of life, an implementation of the platform into Swedish cancer care will be considered. The RECapp platform can play a future role in Swedish cancer care, not only to enhance life for cancer survivors and their relatives but also to achieve health economic benefits.

• Study Type: Interventional
• Enrollment (Estimated): 250
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Pernilla Lagergren, Professor; Phone Number: +46852482758; Email: pernilla.lagergren@ki.se
• Study Contact Backup: Name: Marta Lason; Phone Number: +46852485397; Email: marta.lason@ki.se

Study Locations

• Sweden
  • Gothenburg, Sweden
    • Sahlgrenska University Hospital
    • Contact: Christina Biörserud; Phone Number: +4631-342 84 04; Email: christina.biorserud@vrgregion.se
    • Principal Investigator: Christina Biörserud
  • Linköping, Sweden
    • Linköping University Hospital
    • Contact: David Edholm; Phone Number: +4672-923 78 66; Email: david.edholm@regionostergotland.se
    • Principal Investigator: David Edholm
  • Lund, Sweden
    • Skåne University Hospital
    • Contact: Jan Johansson; Phone Number: +4646-17 14 32; Email: jan.johansson@skane.se
    • Principal Investigator: Jan Johansson
  • Stockholm, Sweden
    • Karolinska University Hospital
    • Contact: Berit Sunde; Phone Number: +468-123 86 721; Email: berit.sunde@ki.se
    • Principal Investigator: Berit Sunde
  • Umeå, Sweden
    • University Hospital of Umeå
    • Contact: Andrianos Tsekrekos; Phone Number: +4676-206 32 58; Email: andrianos.tsekrekos@regionvasterbotten.se
    • Principal Investigator: Andrianos Tsekrekos
  • Uppsala, Sweden
    • Uppsala University Hospital
    • Contact: Jakob Hedberg; Phone Number: +4670-378 59 73; Email: jakob.hedberg@uu.se
    • Principal Investigator: Jakob Hedberg
  • Örebro, Sweden
    • Örebro University Hospital
    • Contact: Eva Szabo; Phone Number: +4619-602 10 00; Email: eva.szabo@regionorebrolan.se
    • Principal Investigator: Eva Szabo

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria

• Patients who have undergone invasive surgery with curative intent for oesophageal or gastric cancer (including salvage surgery)
• ≥18 years of age
• Ability to read, understand, and complete study materials in Swedish, including consent forms, questionnaires, and instructions
• Access to a smartphone or tablet with personal BankID

Exclusion Criteria

- Cognitive impairment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention arm; Standard care after surgery for oesophageal and gastric cancer + RECapp	Device: The RECapp platform; The RECapp platform is a device for oesophageal and gastric cancer patients having undergone invasive surgery as part of the curatively intended treatment regime. It is designed to improve recovery and mitigate symptom burden. The RECapp platform includes a mobile application to be used by patients, the RECapp app, and a web application system to be used by healthcare providers, the RECapp care portal. The RECapp app tracks symptom burden through questionnaires, provides feedback on individual status, and provides self-care advice or alerts patients to contact healthcare based on self-reported symptom burden. The RECapp care portal provides healthcare providers with access to the patients' reported history. The RECapp app is to be used by the patient at home, and the RECapp care portal is to be used by healthcare providers in a healthcare setting.
Other: Control arm; Standard care after surgery for oesophageal and gastric cancer for 6 months, thereafter RECapp in addition to standard care for 6 months.	Device: The RECapp platform; The RECapp platform is a device for oesophageal and gastric cancer patients having undergone invasive surgery as part of the curatively intended treatment regime. It is designed to improve recovery and mitigate symptom burden. The RECapp platform includes a mobile application to be used by patients, the RECapp app, and a web application system to be used by healthcare providers, the RECapp care portal. The RECapp app tracks symptom burden through questionnaires, provides feedback on individual status, and provides self-care advice or alerts patients to contact healthcare based on self-reported symptom burden. The RECapp care portal provides healthcare providers with access to the patients' reported history. The RECapp app is to be used by the patient at home, and the RECapp care portal is to be used by healthcare providers in a healthcare setting.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean modified Memorial Symptom Assessment Scale (MSAS) total score at 13 weeks after hospital discharge	The modified Memorial Symptom Assessment Scale (MSAS) assesses overall symptom burden. The total score is calculated as the mean of item responses and ranges from 0 to 4, with higher scores indicating greater symptom burden.	13 weeks after hospital discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean EORTC QLQ-C30 Summary Score at 26 weeks after hospital discharge	The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) Summary Score is calculated from 13 of the 15 QLQ-C30 scales, excluding the global health status and financial difficulties items. Scores are linearly transformed to a 0-100 scale, with higher scores indicating better health-related quality of life.	26 weeks after hospital discharge
Mean EORTC QLQ-OG25 overall symptom summary score at 26 weeks after hospital discharge	The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Oesophago-Gastric Module 25 (QLQ-OG25) overall symptom summary score is calculated as the mean of all QLQ-OG25 symptom scales and single items after transformation to a 0-100 scale. Higher scores indicate greater oesophago-gastric symptom burden. This summary score is used to provide a single interpretable measure of overall symptom burden.	26 weeks after hospital discharge
Mean modified Memorial Symptom Assessment Scale (MSAS) total score at 26 weeks after hospital discharge	The modified Memorial Symptom Assessment Scale (MSAS) assesses overall symptom burden. The total score is calculated as the mean of item responses and ranges from 0 to 4, with higher scores indicating greater symptom burden.	26 weeks after hospital discharge
Mean Memorial Symptom Assessment Scale (MSAS) physical symptom distress score at 26 weeks after hospital discharge	The Memorial Symptom Assessment Scale (MSAS) physical symptom distress score assesses distress related to physical symptoms. Scores range from 0 to 4, with higher scores indicating greater physical symptom distress.	26 weeks after hospital discharge
Mean Memorial Symptom Assessment Scale (MSAS) psychological symptom distress score at 26 weeks after hospital discharge	The Memorial Symptom Assessment Scale (MSAS) psychological symptom distress score assesses distress related to psychological symptoms. Scores range from 0 to 4, with higher scores indicating greater psychological symptom distress.	26 weeks after hospital discharge
Mean Memorial Symptom Assessment Scale (MSAS) global distress index score at 26 weeks after hospital discharge	The Memorial Symptom Assessment Scale (MSAS) global distress index assesses overall symptom-related distress. Scores range from 0 to 4, with higher scores indicating greater global symptom distress.	26 weeks after hospital discharge
Mean Strategies Used by People to Promote Health (SUPPH-29) self-efficacy score at 26 weeks after hospital discharge	The Strategies Used by People to Promote Health 29-item questionnaire (SUPPH-29) assesses self-care self-efficacy. The score is calculated as the mean of 29 items and ranges from 1 to 5, with higher scores indicating greater self-efficacy.	26 weeks after hospital discharge
Mean HLS19-Q12 general health literacy score at 26 weeks after hospital discharge	The HLS19-Q12 questionnaire assesses general health literacy. Scores are transformed to a 0-100 scale, with higher scores indicating higher health literacy.	26 weeks after hospital discharge
Mean Assessment of Survivor Concerns (ASC) overall score at 26 weeks after hospital discharge	The Assessment of Survivor Concerns (ASC) measures cancer-related and health-related concerns. The overall score is calculated as the mean of five items (excluding the children's health item) and ranges from 1 to 4, with higher scores indicating greater survivor concerns.	26 weeks after hospital discharge

Collaborators and Investigators

• Sponsor: Karolinska Institutet
• Collaborators: Karolinska Trial Alliance
• Investigators: Study Director: Pernilla Lagergren, Professor, Surgical care science, Molecular Medicine and Surgery, Karolinska Institute

Publications and helpful links

Helpful Links

• RECapp's official webpage

Study record dates

Study Major Dates

• Study Start (Estimated): June 15, 2026
• Primary Completion (Estimated): December 15, 2029
• Study Completion (Estimated): December 15, 2029

Study Registration Dates

• First Submitted: May 5, 2026
• First Submitted That Met QC Criteria: June 7, 2026
• First Posted (Actual): June 11, 2026

Study Record Updates

• Last Update Posted (Actual): June 11, 2026
• Last Update Submitted That Met QC Criteria: June 7, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Gastric cancer; Oesophageal cancer; Digital intervention; Symptom monitoring; Post surgery; Self-care advice
• Additional Relevant MeSH Terms: Pathologic Processes; Neoplasms by Site; Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases; Head and Neck Neoplasms; Esophageal Diseases; Pathological Conditions, Signs and Symptoms; Stomach Neoplasms; Esophageal Neoplasms; Disease
• Other Study ID Numbers: RECapp study; VR-2023-02178 (Other Grant/Funding Number: The Swedish Research Council); CF-23 3208 S 01 H (Other Grant/Funding Number: The Swedish Cancer Society); SS-2024-01-04:06 (Other Grant/Funding Number: The Sjöberg Foundation); RS 2024-0781 (Other Grant/Funding Number: Swedish governmental funding of clinical research (ALF))

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No