The effects of neoadjuvant chemoradiotherapy on physical fitness and morbidity in rectal cancer surgery patients

Abstract

NCT01334593.

Myosteatosis is associated with poor physical fitness in patients undergoing hepatopancreatobiliary surgery

“…Combining CPET with CT data could provide a better prediction of clinical outcome compared with either of them alone, as we found that patients with both low O 2 peak and myosteatosis had significantly lower overall survival while low O 2 peak only was not significantly associated with overall survival. Evidence has shown that a higher physical activity and fitness after a cancer diagnosis and its treatments reduce perioperative risk and improve quality of life and post‐operative outcomes including survival …”

“…Evidence has shown that a higher physical activity and fitness after a cancer diagnosis and its treatments reduce perioperative risk and improve quality of life and post-operative outcomes including survival. 11,13,14,50,54,55 Such data raise the obvious hypothesis: Can health outcomes be improved by perioperative interventions targeted at improving body composition and physical fitness? Body composition and fitness modulation as a concept in surgical risk prediction is attractive due its potential reversibility.…”

“…The ability of CPET to identify patients at risk of poor outcomes is used clinically to guide perioperative care and clinical decision making, and it informs about the shared decision‐making process . We have previously reported that selected CPET variables such as oxygen uptake at estimated lactate threshold or anaerobic threshold ( O 2 at AT) and at peak exercise ( O 2 peak) are associated with worse outcome following colorectal surgery and neoadjuvant cancer treatments . Poor physical fitness is highly prevalent in HPB cancer patients and associated with poor post‐operative outcomes and survival …”

“…1,9 We have previously reported that selected CPET variables such as oxygen uptake at estimated lactate threshold or anaerobic threshold ( _ VO 2 at AT) and at peak exercise ( _ VO 2 peak) are associated with worse outcome following colorectal surgery [10][11][12] and neoadjuvant cancer treatments. 13,14 Poor physical fitness is highly prevalent in HPB cancer patients and associated with poor post-operative outcomes and survival. [15][16][17][18][19] Body composition analysed by using a single-slice CT image at the third lumbar vertebra (L3) is strongly correlated with total body skeletal muscle mass.…”

Surgeon perspectives on the use and effects of neoadjuvant chemoradiation in the treatment of rectal cancer: a comprehensive review of the literature

“…Recent studies have relied upon cardiopulmonary surrogates, specifically oxygen uptake, measured prior to and during exercise in assessing the physical fitness of patients. West and colleagues performed a comprehensive prospective observational study in which decreases in the level of physical fitness were demonstrated in patients' post-NACRT [71]. The authors subsequently introduced a structured responsive exercise-training program (SRETP) involving three sessions of exercise per week on a training bike, with assessments of surrogates of physical fitness.…”