TY - JOUR
T1 - Postoperative Exercise Training in Patients with Colorectal Liver Metastases A Randomized Controlled Trial
AU - Thomsen, Simon Nørskov
AU - Krabek, Rikke
AU - Yfanti, Christina
AU - Sjöberg, Stine
AU - Sundberg, Anna
AU - Dalsgaard, Ditte Munch
AU - Thomsen, Laura Mølgaard
AU - Aasvang, Eske Kvanner
AU - Qvortrup, Camilla
AU - Mau-Sørensen, Morten
AU - Pedersen, Bente Klarlund
AU - Larsen, Peter Nørgaard
AU - Sillesen, Martin Hylleholt
AU - Schultz, Nicolai Aagaard
AU - Christensen, Jesper Frank
AU - Simonsen, Casper
N1 - Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/11/11
Y1 - 2024/11/11
N2 - BACKGROUND: Postoperative morbidity can reduce quality of life, physical performance, and tolerability of postoperative chemotherapy in patients with colorectal liver metastases (CRLM). Exercise can improve these outcomes in some cancer populations. However, it remains unknown whether exercise can be delivered in the early postoperative period following surgery for CRLM without increasing the risk of harms.OBJECTIVE: The primary objective was to compare the number of serious adverse events (SAEs) with exercise intervention versus control. The secondary objectives were to compare non-SAEs, chemotherapy dose modifications, patient-reported outcomes, cardiorespiratory fitness, and physical performance.METHODS: Patients with CRLM scheduled to open surgery with or without postoperative chemotherapy were randomized 2:1 to intervention or control. The intervention group performed 30-50 min low-to-high intensity exercise 5 times/week for 8 weeks, initiated one day after postoperative hospital discharge. The primary outcome was SAEs. The secondary outcomes were SAEs; chemotherapy dose modifications; patient-reported outcomes; cardiorespiratory fitness; and physical performance.RESULTS: Fifty-five participants were randomized. The number of SAEs was similar between the groups (between-group difference [95% CI]: -0.07 [-0.59; 0.43] events), whereas the number of non-SAEs was lower in intervention (between-group difference [95% CI]: -4.65 [-9.14; -0.17] events). We found between-group differences in time to postoperative chemotherapy (intervention: 25 days, control; 42 days) and chemotherapy dose modifications (RR [95%CI]: 0.55 [0.35; 0.88]). Additionally, we found between-group differences in quality of life, cardiorespiratory fitness, and physical performance, in favor of intervention.CONCLUSIONS: Early-onset postoperative exercise exhibit a favorable harms-benefit profile in patients with CRLM. This warrants further investigation in larger randomized controlled trials.TRIAL REGISTRATION: Prospectively registered at clinicaltrials.gov (NCT04751773).
AB - BACKGROUND: Postoperative morbidity can reduce quality of life, physical performance, and tolerability of postoperative chemotherapy in patients with colorectal liver metastases (CRLM). Exercise can improve these outcomes in some cancer populations. However, it remains unknown whether exercise can be delivered in the early postoperative period following surgery for CRLM without increasing the risk of harms.OBJECTIVE: The primary objective was to compare the number of serious adverse events (SAEs) with exercise intervention versus control. The secondary objectives were to compare non-SAEs, chemotherapy dose modifications, patient-reported outcomes, cardiorespiratory fitness, and physical performance.METHODS: Patients with CRLM scheduled to open surgery with or without postoperative chemotherapy were randomized 2:1 to intervention or control. The intervention group performed 30-50 min low-to-high intensity exercise 5 times/week for 8 weeks, initiated one day after postoperative hospital discharge. The primary outcome was SAEs. The secondary outcomes were SAEs; chemotherapy dose modifications; patient-reported outcomes; cardiorespiratory fitness; and physical performance.RESULTS: Fifty-five participants were randomized. The number of SAEs was similar between the groups (between-group difference [95% CI]: -0.07 [-0.59; 0.43] events), whereas the number of non-SAEs was lower in intervention (between-group difference [95% CI]: -4.65 [-9.14; -0.17] events). We found between-group differences in time to postoperative chemotherapy (intervention: 25 days, control; 42 days) and chemotherapy dose modifications (RR [95%CI]: 0.55 [0.35; 0.88]). Additionally, we found between-group differences in quality of life, cardiorespiratory fitness, and physical performance, in favor of intervention.CONCLUSIONS: Early-onset postoperative exercise exhibit a favorable harms-benefit profile in patients with CRLM. This warrants further investigation in larger randomized controlled trials.TRIAL REGISTRATION: Prospectively registered at clinicaltrials.gov (NCT04751773).
UR - http://www.scopus.com/inward/record.url?scp=85209643262&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000006587
DO - 10.1097/SLA.0000000000006587
M3 - Journal article
C2 - 39523954
SN - 0003-4932
JO - Annals of Surgery
JF - Annals of Surgery
M1 - 10.1097/SLA.0000000000006587
ER -