Preoperative exercise halves the postoperative complication rate in patients with lung cancer: a systematic review of the effect of exercise on complications, length of stay and quality of life in patients with cancer

2018 ◽  
Vol 52 (5) ◽  
pp. 344-344 ◽  
Author(s):  
Daniel Steffens ◽  
Paula R Beckenkamp ◽  
Mark Hancock ◽  
Michael Solomon ◽  
Jane Young
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Systematic Review ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Postoperative Complication ◽  
Length Of Hospital Stay ◽  
Oncological Surgery ◽  
Preoperative Exercise

ObjectiveTo investigate the effectiveness of preoperative exercises interventions in patients undergoing oncological surgery, on postoperative complications, length of hospital stay and quality of life.DesignIntervention systematic review with meta-analysis.Data sourcesMEDLINE, Embase and PEDro.Eligibility criteria for selecting studiesTrials investigating the effectiveness of preoperative exercise for any oncological patient undergoing surgery were included. The outcomes of interest were postoperative complications, length of hospital stay and quality of life. Relative risks (RRs), mean differences (MDs) and 95% CI were calculated using random-effects models.ResultsSeventeen articles (reporting on 13 different trials) involving 806 individual participants and 6 tumour types were included. There was moderate-quality evidence that preoperative exercise significantly reduced postoperative complication rates (RR 0.52, 95% CI 0.36 to 0.74) and length of hospital stay (MD −2.86 days, 95% CI −5.40 to −0.33) in patients undergoing lung resection, compared with control. For patients with oesophageal cancer, preoperative exercise was not effective in reducing length of hospital stay (MD 2.00 days, 95% CI −2.35 to 6.35). Although only assessed in individual studies, preoperative exercise improved postoperative quality of life in patients with oral or prostate cancer. No effect was found in patients with colon and colorectal liver metastases.ConclusionsPreoperative exercise was effective in reducing postoperative complications and length of hospital stay in patients with lung cancer. Whether preoperative exercise reduces complications, length of hospital stay and improves quality of life in other groups of patients undergoing oncological surgery is uncertain as the quality of evidence is low.PROSPEROregistration number

scholarly journals Exercise Training for Patients Pre- and Postsurgically Treated for Non–Small Cell Lung Cancer: A Systematic Review and Meta-analysis

2016 ◽  
Vol 16 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Hui-Juan Ni ◽  
Bigyan Pudasaini ◽  
Xun-Tao Yuan ◽  
He-Fang Li ◽  
Lei Shi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Exercise Training ◽  
Hospital Stay ◽  
Exercise Capacity ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Small Cell Lung ◽  
Preoperative Exercise

Background. This meta-analysis examined the effects of exercise training on length of hospital stay, postoperative complications, exercise capacity, 6-minute walking distance (6MWD), and health-related quality of life (HRQoL) in patients following resection of non–small cell lung cancer (NSCLC). Methods. This review searched PubMed, EMBASE, and the Cochrane Collaboration data base up to August 16, 2015. It includes 15 studies comparing exercise endurance and quality of life before versus after exercise training in patients undergoing lung resection for NSCLC. Results. This review identified 15 studies, 8 of which are randomized controlled trials including 350 patients. Preoperative exercise training shortened length of hospital stay; mean difference (MD): −4.98 days (95% CI = −6.22 to −3.74, P < .00001) and also decreased postoperative complications for which the odds ratio was 0.33 (95% CI = 0.15 to 0.74, P = .007). Four weeks of preoperative exercise training improved exercise capacity; 6MWD was increased to 39.95 m (95% CI = 5.31 to 74.6, P = .02) .While postoperative exercise training can also effectively improve exercise capacity, it required a longer training period; 6MWD was increased to 62.83 m (95% CI = 57.94 to 67.72) after 12 weeks of training ( P < .00001). For HRQoL, on the EORTC-QLQ-30, there were no differences in patients’ global health after exercise, but dyspnea score was decreased −14.31 points (95% CI = −20.03 to −8.58, P < .00001). On the SF-36 score, physical health was better after exercise training (MD = 3 points, 95% CI = 0.81 to 5.2, P = .007) while there was no difference with regard to mental health. The I2 statistics of all statistically pooled data were lower than 30%. There was a low amount of heterogeneity among these studies. Conclusions. Evidence from this review suggests that preoperative exercise training may shorten length of hospital stay, decrease postoperative complications and increase 6MWD. Postoperative exercise training can also effectively improve both the 6MWD and quality of life in surgical patients with NSCLC, but requiring a longer training period.

scholarly journals What are the impact and the optimal design of a physical prehabilitation program in patients with esophagogastric cancer awaiting surgery? A systematic review

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Elise Piraux ◽  
Gregory Reychler ◽  
Louise Maertens de Noordhout ◽  
Patrice Forget ◽  
Yannick Deswysen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Tumor Resection ◽  
Length Of Hospital Stay ◽  
Randomized Controlled ◽  
Esophagogastric Cancer ◽  
Related Quality ◽  
Health Related ◽  
Preoperative Exercise

Abstract Background Substantial postoperative complications occur after tumor resection for esophagogastric cancers. Physical prehabilitation programs aim to prepare patients for surgery by improving their functional status with the aim of reducing postoperative complications. This systematic review aims to summarize the effects of physical prehabilitation programs on exercise capacity, muscle strength, respiratory muscle function, postoperative outcomes, and health-related quality of life and to determine the optimal design of such a program to improve these outcomes in esophagogastric cancer patients undergoing tumor resection. Methods A systematic literature review was conducted using PubMed, The Cochrane Library, Scopus, and PEDro databases to identify studies evaluating the effects of physical prehabilitation program on exercise capacity, muscle strength, respiratory muscle function, postoperative complications, length of hospital stay, mortality, and health-related quality of life in patients with esophagogastric cancer awaiting surgery. Data from all studies meeting the inclusion criteria were extracted. The quality of each selected study was determined using the Downs and Black checklist. Results Seven studies with 645 participants were included. The preoperative exercise program consisted of respiratory training alone in three studies, a combination of aerobic and resistance training in two studies, and a combination of respiratory, aerobic, and resistance training in two studies. Training frequency ranged from three times a day to twice a week and each session lasted between 20 and 75 min. Four studies were of fair quality and three of good quality. Some studies reported improvements in maximal inspiratory pressure, inspiratory muscle endurance, postoperative (pulmonary) complications, and length of hospital stay in the preoperative exercise group compared to the control group. Conclusion This systematic review reports the current evidence for physical prehabilitation programs in patients with esophagogastric cancer awaiting surgery. However, due to the limited number of randomized controlled trials, the significant heterogeneity of exercise programs, and the questionable quality of the studies, higher quality randomized controlled trials are needed. Trial registration PROSPERO Registration Number: CRD42020176353.

scholarly journals Early Clinically Relevant Improvement in Quality of Life and Clinical Outcomes 1 Year Postsurgery in Patients with Knee and Hip Joint Arthroplasties

Cartilage ◽  
2017 ◽  
Vol 9 (2) ◽  
pp. 127-139 ◽  
Author(s):  
Audrey Neuprez ◽  
Arnaud H. Neuprez ◽  
Jean-François Kaux ◽  
William Kurth ◽  
Christophe Daniel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Minimal Important Difference ◽  
Length Of Hospital Stay ◽  
Good Outcome ◽  
Related Quality ◽  
Health Related ◽  
Joint Arthroplasties

Objective To measure and identify the determinants of the outcomes after hip/knee arthroplasty (HA/KA) in patients with osteoarthritis during the first postsurgical year. Design In this prospective observational study, we evaluated the preoperative and postoperative (3, 6, and 12 months) outcomes of 626 patients who underwent HA (346 with median age 65 years, 59% female) or KA (280 with median age 66.5 years, 54% female) between 2008 and 2013. Generic and specific tools were used to measure health-related quality of life (HRQoL) and utility. Good outcome was defined as an improvement in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) greater than or equal to the minimal important difference (MID). Regressions were performed to evaluate the relationship between preoperative and postoperative measures and evolution of WOMAC/good outcome. Results We observed an almost systematic improvement of all parameters for up to 12 months, but especially at the 3-month follow-up. The low number of comorbidities and the absence of postoperative complications were the common determinants of improvement of WOMAC total score after 12 months. Other parameters (background of the joint, preoperative function and length of hospital stay in KA group; place of discharge in HA group) affected the evolution of WOMAC scores. 87.09% of HA and 73.06% of KA patients experienced a good outcome. A small number of comorbidities, a worse preoperative function, a shortened hospital stay (KA only), and an absence of early postoperative complications (HA only) significantly predicted a good outcome. Conclusions Intermediate HRQoL following HA or KA improved quickly from preoperative levels for all instruments. More than 70% of patients achieved a good outcome defined as improved pain, stiffness and disability and the predictors are slightly close.

scholarly journals Effectiveness of comprehensive geriatric assessment intervention on quality of life, caregiver burden and length of hospital stay: a systematic review and meta-analysis of randomised controlled trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhongyi Chen ◽  
Zhaosheng Ding ◽  
Caixia Chen ◽  
Yangfan Sun ◽  
Yuyu Jiang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Stay ◽  
Usual Care ◽  
Caregiver Burden ◽  
Length Of Hospital Stay ◽  
Sf 36 ◽  
Subgroup Analyses ◽  
Randomised Controlled ◽  
Meta Analyses

Abstract Background Comprehensive geriatric assessment (CGA) interventions can improve functional ability and reduce mortality in older adults, but the effectiveness of CGA intervention on the quality of life, caregiver burden, and length of hospital stay remains unclear. The study aimed to determine the effectiveness of CGA intervention on the quality of life, length of hospital stay, and caregiver burden in older adults by conducting meta-analyses of randomised controlled trials (RCTs). Methods A literature search in PubMed, Embase, and Cochrane Library was conducted for papers published before February 29, 2020, based on inclusion criteria. Standardised mean difference (SMD) or mean difference (MD) with 95% confidence intervals (CIs) was calculated using the random-effects model. Subgroup analyses, sensitivity analyses, and publication bias analyses were also conducted. Results A total of 28 RCTs were included. Overall, the intervention components common in different CGA intervention models were interdisciplinary assessments and team meetings. Meta-analyses showed that CGA interventions improved the quality of life of older people (SMD = 0.12; 95% CI = 0.03 to 0.21; P = 0.009) compared to usual care, and subgroup analyses showed that CGA interventions improved the quality of life only in participants’ age > 80 years and at follow-up ≤3 months. The change value of quality of life in the CGA intervention group was better than that in the usual care group on six dimensions of the 36-Item Short-Form Health Survey questionnaire (SF-36). Also, compared to usual care, the CGA intervention reduced the caregiver burden (SMD = − 0.56; 95% CI = − 0.97 to − 0.15, P = 0.007), but had no significant effect on the length of hospital stay. Conclusions CGA intervention was effective in improving the quality of life and reducing caregiver burden, but did not affect the length of hospital stay. It is recommended that future studies apply the SF-36 to evaluate the impact of CGA interventions on the quality of life and provide supportive strategies for caregivers as an essential part of the CGA intervention, to find additional benefits of CGA interventions.

scholarly journals A Systematic Review of Quality of Life Associated with Standard Chemotherapy Regimens for Advanced Non-small Cell Lung Cancer

2007 ◽  
Vol 2 (12) ◽  
pp. 1091-1097 ◽  
Author(s):  
Tawee Tanvetyanon ◽  
Heloisa P. Soares ◽  
Benjamin Djulbegovic ◽  
Paul B. Jacobsen ◽  
Gerold Bepler
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Systematic Review ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Standard Chemotherapy

scholarly journals Use of the lung cancer-specific Quality of Life Questionnaire EORTC QLQ-LC13 in clinical trials: A systematic review of the literature 20 years after its development

Cancer ◽  
2015 ◽  
Vol 121 (24) ◽  
pp. 4300-4323 ◽  
Author(s):  
Michael Koller ◽  
Sophie Warncke ◽  
Marianne J. Hjermstad ◽  
Juan Arraras ◽  
Cecilia Pompili ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Systematic Review ◽  
Clinical Trials ◽  
Life Questionnaire ◽  
Review Of The Literature ◽  
Quality Of Life Questionnaire ◽  
Eortc Qlq

The ideal amount of physical activity to improve quality of life and symptoms in lung cancer patients: A systematic review.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23158-e23158
Author(s):  
Gilberto Castro ◽  
Alberto Codima ◽  
Willian das Neves ◽  
Ana Paula Souza Borges
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Lung Cancer ◽  
Systematic Review ◽  
Cancer Patients ◽  
Risk Of Bias ◽  
Improve Quality ◽  
Eligibility Criteria ◽  
Lung Cancer Patients

e23158 Background: The symptoms which burden lung cancer patients contribute to a vicious cycle of physical inactivity as the disease progresses. Some studies have shown that exercise is feasible and safe for this population, and it improves their symptoms and quality of life. However, the current recommendations are non-specific, and little is known about the optimal amount and type of exercise in this scenario. Here we aimed to identify a specific recommendation of physical activity that could work more efficiently, benefiting lung cancer patients, in terms of diminishing their symptom burden and improving quality of life. Methods: A systematic review was undertaken through structured searches on PubMed, Medline, Embase, Scopus, Web of Science and SciELO. The search protocol was registered on the Prospero platform. Rayyan QCRI was used for data extraction and determining eligible studies after a blind screening of titles and abstracts by the three authors. The Physiotherapy Evidence Database (PEDro) scale was used for quality assessment of each eligible trial in regards of risk of bias. Trials which had clear eligibility criteria and a summary score equal or superior than 6 were considered to have low risk of bias, and accepted for full text review. Results: From September/1998 to January/2019, a total amount of 1998 studies were returned from the aforementioned databases, and 17 studies were established to be eligible for quality assessment. All the 17 quality-assessed studies were randomized clinical trials. However, two of them did not clearly report the eligibility criteria and were immediately excluded. Five other studies were considered to have high risk of bias. Therefore, we considered only 10 trials to be fully reviewed, including 843 patients. Only 3 trials found significant improvement in the quality of life after their interventions, and included 243 patients. Two studies associated aerobic exercise and resistance training from 10 to 20 weeks post surgery, while the other studied intervention was Tai Chi for 10 days after each chemotherapy cycle. Conclusions: Evidence from this review suggests that exercise may improve quality of life of lung cancer patients. However, we could not identify an ideal amount nor type of physical activity given the limited available data and the heterogeneity of methods. Further studies are warranted.

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

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-217242
Author(s):  
Francis-Edouard Gravier ◽  
Pauline Smondack ◽  
Guillaume Prieur ◽  
Clement Medrinal ◽  
Yann Combret ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Postoperative Complications ◽  
Exercise Training ◽  
Small Cell Lung Cancer ◽  
Meta Analysis ◽  
Lung Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Preoperative Exercise

IntroductionExercise training before lung resection for non-small cell lung cancer is believed to decrease postoperative complications (POC) by improving cardiorespiratory fitness. However, this intervention lacks a strong evidence base.AimTo assess the effectiveness of preoperative exercise training compared with usual care on POC and other secondary outcomes in patients with scheduled lung resection.MethodsA systematic search of randomised trials was conducted by two authors. Meta-analysis was performed, and the effect of exercise training was estimated by risk ratios (RR) and mean differences, with their CIs. Clinical usefulness was estimated according to minimal important difference values (MID).ResultsFourteen studies involving 791 participants were included. Compared with usual care, exercise training reduced overall POC (10 studies, 617 participants, RR 0.58, 95% CI 0.45 to 0.75) and clinically relevant POC (4 studies, 302 participants, Clavien-Dindo score ≥2 RR 0.42, 95% CI 0.25 to 0.69). The estimate of the effect of exercise training on mortality was very imprecise (6 studies, 456 participants, RR 0.66, 95% CI 0.20 to 2.22). The main risks of bias were a lack of participant blinding and selective reporting. Exercise training appeared to improve exercise capacity, pulmonary function and also quality of life and depression, although the clinical usefulness of the changes was unclear. The quality of the evidence was graded for each outcome.ConclusionPreoperative exercise training leads to a worthwhile reduction in postoperative complications. These estimates were both accurate and large enough to make recommendations for clinical practice.

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