Are VO2PEAK prediction equations accurate in predicting VO2PEAK in presurgical oncology patients?

Abstract

e19578 Background: Quantitative presurgical fitness status (VO2PEAK) provides very useful but difficult to obtain patient information. The purpose of this study therefore was to determine if equations that use anthropometric measures to predict VO2PEAK might accurately predict VO2PEAK in recently diagnosed, presurgical cancer patients. Methods: After receiving physician clearance, 111 subjects (83 males, 28 females) with abdominal, gastrointestinal, and urinary tract tumors underwent a standard ramp bicycle ergometer cardiopulmonary exercise test within two weeks of scheduled surgery. The exercise protocol sequentially entailed 3 min of quiet resting, 3 min of unloaded cycling, ramp protocol to peak exercise tolerance, and 3 min of recovery. Ramp rates (5-25 W/min) were individually chosen to achieve standard test durations of 8-12 min per patient. Tests were symptom limited and considered peak if the subject achieved >85% of predicted heart rate and a respiratory exchange ratio > 1.1. Measured VO2PEAK results (ml/min) were compared with VO2PEAK values predicted by the equations of Neder et al, Eur. Respir. J. 1999; Fairborn et al, Chest. 1994; Storer et al, Med Sci. Sport Exer. 1990, Jones et al. Am. Rev Respir. Dis. 1985. The UT M. D. Anderson Cancer Center Institutional Review Board approved this study. Statistical analysis: The strength of the relationship between measured and predicted VO2PEAK values was measured by correlational analysis. Similarity between the means of the measured vs. predicted VO2PEAK values was determined using a paired t-test (p < 0.05). Results: Only the results from the Storer et al equation were found to be both highly correlated with and statistically similar to the measured values. Conclusions: Results suggest that the Storer et al equation provides accurate estimates of VO2PEAK in this particular patient population. Such information would provide insight into 1) the presurgical fitness status of this group of cancer patients, 2) their need for presurgical reconditioning and 3) their postsurgical risk for adverse outcomes. Measured Neder et al Fairborn et al Storer et al Jones et al Pearson r 0.2168 0.7444 0.9347 0.7002 P value 0.0000 0.0355 0.5801 0.0000