Supportive Care in Cancer

, Volume 24, Issue 5, pp 2277–2285

Structured exercise program prior to major cancer surgery improves cardiopulmonary fitness: a retrospective cohort study

  • Grace H. Huang
  • Hilmy Ismail
  • Andrew Murnane
  • Pascal Kim
  • Bernhard Riedel
Original Article

DOI: 10.1007/s00520-015-3028-7

Cite this article as:
Huang, G.H., Ismail, H., Murnane, A. et al. Support Care Cancer (2016) 24: 2277. doi:10.1007/s00520-015-3028-7

Abstract

Purpose

To determine if cardiopulmonary exercise testing (CPET) was useful in predicting response to exercise in cancer patients preoperatively. A secondary aim was to explore if exercise was associated with improved postoperative outcomes.

Methods

A retrospective cohort study was performed on consecutive cancer patients from 2012 to 2014, referred for exercise prehabilitation and had two CPET preoperatively.

Results

Twenty-six patients were analysed. There was a significant overall increase in oxygen uptake at anaerobic threshold (AT) from 10.4 to 11.6 ml kg−1 min−1 (ΔAT = 1.2 ± 3.0 ml kg−1 min−1 [9 %]; p = 0.046); peak oxygen uptake (pVO2) from 16.0 to 17.7 ml kg−1 min−1 (ΔpVO2 = 1.7 ± 2.4 ml kg−1 min−1 [9 %]; p = 0.002); and pVO2/BSA from 658 to 726 ml min−1 m−2; (ΔpVO2/BSA = 68 ± 112.3 mL min−1 m2 [10 %]; p = 0.004). Fifty percent of patients were responders to exercise, defined as having >10 % increase in AT. Responders had a median increase in AT of 26 % [IQR 7 %, 45 %] with an absolute increase in AT of 2.5 ml kg−1 min−1 [IQR 1.1, 3.9] (p = 0.002) and a median increase in pVO2 of 22 % [IQR 11.5, 32.5 %] with an absolute increase in pVO2 of 3.8 ml.kg−1.min−1 [IQR 2.0, 5.7] (p < 0.001). Responders were more likely to have a lower baseline AT (9.1 ml kg−1 min−1; p = 0.002).

Conclusions

Exercise improved cardiorespiratory fitness prior to major cancer surgery. Not all patients responded the same, with only 50 % of the study cohort being responders to exercise. A low AT, pVO2 and ratio of AT/pVO2 at baseline were good predictors of response to exercise, with a tendency for responders to suffer fewer major postoperative complications.

Keywords

Exercise Prehabilitation Cancer surgery Cardiopulmonary fitness 

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Grace H. Huang
    • 1
    • 4
  • Hilmy Ismail
    • 1
  • Andrew Murnane
    • 2
  • Pascal Kim
    • 3
  • Bernhard Riedel
    • 1
  1. 1.Department of Anaesthesia, Perioperative and Pain MedicinePeter MacCallum Cancer CentreMelbourneAustralia
  2. 2.Department of PhysiotherapyPeter MacCallum Cancer CentreMelbourneAustralia
  3. 3.Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain TherapyKantonsspital LucerneLucerneSwitzerland
  4. 4.Department of Anaesthesia and Pain ManagementWestern HealthFootscrayAustralia

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