17047 Background: Exercise capacity is a strong independent predictor of surgical outcome in patients with operable NSCLC and thus an established clinical tool to assess preoperative eligibility. The purpose of this study was to determine the effects of preoperative exercise training on exercise capacity in operable lung cancer. Methods: Using a single-group design, participants with suspected operable lung cancer were screened for eligibility at the time of diagnosis. Twenty-six patients were recruited and offered exercise training until surgical resection. Exercise training consisted of 5 endurance cycle ergometry sessions per week at 60 to 100% of patient’s baseline exercise capacity. Patients underwent cardiopulmonary exercise testing (CPET) including peak oxygen consumption (VO2peak), six minute walk distance (6MWD), and a pulmonary function test at baseline, immediately prior and 30 days post surgical resection. Results: The mean time from diagnosis to resection was 67 ± 27 days. During this time, 6 patients were deemed ineligible and were removed from the analysis. Of the remaining 20 patients, 18 completed exercise training and 13 performed CPET post resection. The overall adherence rate was 72% (range 0%–100%) with patients completing a mean of 30 exercise sessions (range 0–75). Intention-to-treat analysis indicated that VO2peak and 6MWD increased by 2.3 mL · kg−1 · min−1 [95% CI, 1.0 to 3.7; p = .002] and 40m [95% CI, 16 to 64; p=.003] respectively, from baseline to presurgery but decreased from pre to post resection [VO2peak, −2.7 mL · kg−1 · min−1, 95% CI, −3.9 to −1.6; p < .001; 6 MWD, −44 m, 95% CI, −94 to 6.4; p = .082]. There were no differences between baseline and postsurgical exercise capacity. Per protocol analyses indicated that patients who achieved acceptable exercise adherence (≥80% of prescribed sessions, n = 12) increased VO2peak and 6MWD by 3.2 mL · kg−1 · min−1 [95% CI, 1.1 to 5.4; p = .005] and 49 meters [95% CI, 12 to 85; p = .013], respectively. Conclusion: Preoperative exercise training is associated with improvements in exercise capacity in patients with operable NSCLC, particularly if acceptable adherence is achieved. This benefit may have important implications for surgical outcome and postsurgical recovery in this population. No significant financial relationships to disclose.
Is Preoperative Exercise Training the New Holy Grail for Patients Undergoing Major Surgery?
