Effects of exercise training in people with non-small cell lung cancer before lung resection: a systematic review and meta-analysis

Gravier, Francis‐Edouard; Smondack, Pauline; Prieur, Guillaume; Medrinal, Clément; Combret, Yann; Muir, Jean-François; Baste, Jean-Marc; Cuvelier, A.; Boujibar, Fairuz; Bonnevie, Tristan

doi:10.1183/13993003.congress-2021.oa2636

Cited by 4 publications

(6 citation statements)

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“…Exercise prehabilitation effectively reduces the occurrence of postoperative complications and reduces length of hospital stay in patients undergoing surgery for NSCLC (13,14). Patients need to be informed about the bene ts of improving their health status before surgery, preferably by a physician (18).…”

Section: Discussionmentioning

confidence: 99%

“…A multimodal prehabilitation program, including aerobic, resistance, and/or inspiratory muscle training, nutritional advice, and/or support for smoking-cessation, can reduce the risk of postoperative complications after surgery in patients with NSCLC (8,11,12). Moreover, prehabilitation can decrease the length of hospital stay and facilitate postoperative recovery (12)(13)(14). Despite the effectiveness of prehabilitation, it is not yet part of usual care.…”

Section: Introductionmentioning

confidence: 99%

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A qualitative stakeholder analysis of beliefs, facilitators, and barriers for a feasible prehabilitation program before lung cancer surgery

Voorn

Bastiaansen²,

Schröder³

et al. 2023

Preprint

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Background In order to develop a feasible prehabilitation program before surgery of NSCLC, this study aimed to gain insight into beliefs, facilitators, and barriers of 1) healthcare professionals to refer patients to a prehabilitation program, 2) patients to participate in and adhere to a prehabilitation program, and 3) informal caregivers to support their loved ones. Methods Semi-structured interviews were conducted with healthcare professionals, patients who underwent surgery for NSCLC, and their informal caregivers. The capability, opportunity, and motivation for behavior-model (COM-B) guided the development of the interview questions. Results were analyzed thematically. Results The interviews were conducted with twelve healthcare professionals, seventeen patients, and sixteen informal caregivers. Healthcare professionals mentioned that professionals should facilitate the referral of patients to prehabilitation within primary and secondary healthcare involved in prehabilitation, considering the short preoperative period. Patients did not know that a better preoperative physical fitness and nutritional status would make a difference in the risk of postoperative complications. Patients indicated that they want to receive information about the aim and possibilities of prehabilitation. Most patients preferred a group-based physical exercise training program organized in their living context in primary care. Informal caregivers could support their loved one. Conclusion A prehabilitation program should be started as soon as possible after the diagnosis of lung cancer. Receiving information about the purpose and effects of prehabilitation in a consult with a physician seems crucial to patients to be involved in prehabilitation. Support of loved ones in the patient’s own living context is essential for adherence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A qualitative stakeholder analysis of beliefs, facilitators, and barriers for a feasible prehabilitation program before lung cancer surgery

Voorn

Bastiaansen²,

Schröder³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…6,7 A recent meta-analysis of RCTs of exercise training before lung cancer surgery demonstrated a significant reduction in the rate of postoperative complications (risk ratio 0.42; 95% confidence interval [CI]: 0.25e0.69), postoperative length of stay in hospital (mean difference e2.29 days; 95% CI: e0.98 to e3.59), and improved exercise capacity (6 min walk distance mean difference þ37.6 m; 95% CI: þ20.5 to þ54.7). 8 Given this strong evidence supporting the efficacy of prehabilitation before lung cancer surgery alongside the increasing volume of lung cancer surgery, service delivery is the primary challenge.…”

Section: Editor's Key Pointsmentioning

confidence: 99%

“…In the pilot programme, patients with lung cancer were eligible for P4C if surgical resection was planned, as it is this cohort of patients who have the clearest evidence of benefit. 8 The inclusion criteria were lung cancer MDT-agreed diagnosis of primary lung cancer with a treatment recommendation of surgical resection, aged 18 yr or over, registered with a GM primary care service, able to access the programme either independently or with support from a carer/family member, indicated informed consent to be referred, and walked more than 250 m on the incremental shuttle walk test (ISWT). As a community programme without clinical facility support, embedded risk assessment at all stages of the pathway was crucial to mitigate the risk of adverse events during prehabilitation.…”

Section: Lung Cancer P4c Pathwaymentioning

confidence: 99%

Feasibility and outcomes of a real-world regional lung cancer prehabilitation programme in the UK

Bradley¹,

Merchant²,

Rowlinson-Groves³

et al. 2023

British Journal of Anaesthesia

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“…Pre-habilitation has shown to increase exercise capacity and significantly enhance pulmonary function (17) and metaanalytical data has subsequently demonstrated a robust reduction in post-operative complications as a result (18).…”

Section: The High-risk Thoracic Surgical Patientmentioning

confidence: 99%

Lung cancer resection in high-risk patients: a narrative review

Patel¹,

Bishay²,

Naidu³

2022

Shanghai Chest

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Background and Objective: The National Lung Cancer Audit (NLCA) 2022 report showed that for England in 2019, the curative treatment rates of non-small cell lung cancer (NSCLC) patients with stage I/II disease and good performance status were 81%, this metric fell to 73% in 2020 with resection rates falling from 20% to 15%. The impact of COVID-19 could well have influenced this and indeed lung cancer patients diagnosed in 2020 were more likely to have a worse performance status, diagnosed as emergency presentations and less likely to have a pathological diagnosis. Assessing risk in the current era and defining which patients are high-risk needs formal exploration and definition if we are to improve resection rates in a safe and equitable manner. Methods:We conducted a narrative literature review to explore the paradigm of risk in thoracic surgery and in particular address the concept of what is considered to be "high risk" for surgery. We searched MEDLINE, EMBASE and Cochrane Library databases using the OVID interface. We reviewed articles between January 1, 2000, and December 31, 2021 and restricted this to full text papers only in the English language. Conference abstracts were not considered.

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Effects of exercise training in people with non-small cell lung cancer before lung resection: a systematic review and meta-analysis

Cited by 4 publications

References 0 publications

A qualitative stakeholder analysis of beliefs, facilitators, and barriers for a feasible prehabilitation program before lung cancer surgery

A qualitative stakeholder analysis of beliefs, facilitators, and barriers for a feasible prehabilitation program before lung cancer surgery

Feasibility and outcomes of a real-world regional lung cancer prehabilitation programme in the UK

Lung cancer resection in high-risk patients: a narrative review

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