For the functional capacity and medical care parameters , preoperative combined aerobic , resistance , and inspiratory muscle training was shown to be effective if comprising one to four weeks , performing 1 - 3 sessions per week , with moderate intensity ( 50 % for endurance capacity ) .
Preoperative physical exercise protocol s prior to cancer surgery increased in popularity over recent years ; however , the beneficial effect of such protocol s is not well established , with conflicting results reported .
We conducted a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) to assess the effects of different modalities or combinations of preoperative exercise interventions and /or prehabilitation multicomponent training in patients with non-small-cell lung cancer ( NSCLC ) after surgery on the outcomes related to functional capacity , mental wellness and medical care .
The effect of neoadjuvant chemotherapy on physical fitness and survival in patients undergoing oesophagogastric cancer surgery.
BACKGROUND Neoadjuvant chemotherapy ( NAC ) followed by surgery for resectable oesophageal or gastric cancer improves outcome when compared with surgery alone . However NAC has adverse effects . We assess here whether NAC adversely affects physical fitness and whether such an effect is associated with impaired survival following surgery . METHODS We prospect ively studied 116 patients with oesophageal or gastric cancer to assess the effect of NAC on physical fitness , of whom 89 underwent cardiopulmonary exercise testing ( CPET ) before NAC and proceeded to surgery . 39 patients were tested after all cycles of NAC but prior to surgery . Physical fitness was assessed by measuring oxygen uptake ( VO₂ in ml kg(-1 ) min(-1 ) ) at the estimated lactate threshold ( θL ) and at peak exercise ( VO₂ peak in ml kg(-1 ) min(-1 ) ) . RESULTS VO₂ at θL and at peak were significantly lower after NAC compared to pre-NAC values : VO₂ at θL 14.5 ± 3.8 ( baseline ) vs. 12.3 ± 3.0 ( post-NAC ) ml kg(-1 ) min(-1 ) ; p ≤ 0.001 ; VO₂ peak 20.8 ± 6.0 vs. 18.3 ± 5.1 ml kg(-1 ) min(-1 ) ; p ≤ 0.001 ; absolute VO₂ ( ml min(-1 ) ) at θL and peak were also lower post-NAC ; p ≤ 0.001 . Decreased baseline VO₂ at θL and peak were associated with increased one year mortality in patients who completed a full course of NAC and had surgery ; p = 0.014 . CONCLUSION NAC before cancer surgery significantly reduced physical fitness in the overall cohort . Lower baseline fitness was associated with reduced one-year-survival in patients completing NAC and surgery , but not in patients who did not complete NAC . It is possible that in some patients the harms of NAC may outweigh the benefits . Trials Registry Number : NCT01335555
For the functional capacity and medical care parameters , preoperative combined aerobic , resistance , and inspiratory muscle training was shown to be effective if comprising one to four weeks , performing 1 - 3 sessions per week , with moderate intensity ( 50 % for endurance capacity ) .
Preoperative physical exercise protocol s prior to cancer surgery increased in popularity over recent years ; however , the beneficial effect of such protocol s is not well established , with conflicting results reported .
We conducted a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) to assess the effects of different modalities or combinations of preoperative exercise interventions and /or prehabilitation multicomponent training in patients with non-small-cell lung cancer ( NSCLC ) after surgery on the outcomes related to functional capacity , mental wellness and medical care .