Effects Of Postoperative Recovery Exercise Program On Body Composition, Functional Assessment, Depression, Fatigue, And Inflammatory Markers In Early Gastric Cancer Survivors

Abstract

PURPOSE: This study investigated the effects of postoperative recovery exercise program developed specifically for gastric cancer patients (PREP-GC) on body composition, functional assessment, depression, fatigue, and inflammatory markers in early gastric cancer survivors. METHODS: Twenty gastric cancer patients had minimally invasive gastrectomy and completed the PREP-GC after the surgery. The PRER-GC comprised a) in-hospital exercise for 1 week, b) home exercise for 1 week, and c) fitness improvement exercise for eight weeks. The fitness improvement exercise program consisted the combination of aerobic and resistance exercise for 60 minutes/sesion for 3 times per week. All measurements including body composition, functional assessment, depression, fatigue, and inflmamatory markers (e.g., WBC count, CRP, etc) were assessed during the preoperative period (T1), after postoperative recovery (2 weeks after surgery; T2), and after completing the PREP-GC (10 weeks after surgery; T3). Twenty additional gastric cancer patients (age-, sex-, and BMI-matched) were also recruited to compare inflammatory markers with those patients in the PREP-GC across intervention. RESULTS: Body weight (64.5 ± 11.2 vs. 59.9 ± 9.3 kg), body mass index (23.6 ± 3.0 vs. 21.9 ± 2.5 kg/m2), body fat mass (17.1 ± 1.5 vs. 13.4 ± 1.2 kg), and waist-to-hip ratio (0.87 ± 0.5 vs. 0.84 ± 0.5) were significantly reduced from T1 to T3 (all p< 0.05). The skeletal muscle mass was also reduced after surgery (T1 vs T2: 26.6 ± 5.5 vs. 25.5 ± 5.3, p<0.001), but it significantly increased after the PREP-GC (T2 vs. T3: 25.5 ± 5.3 vs. 26.1 ± 5.5 kg, p = 0.013). There were no statistical differences in social and functional well-being (p>0.05), but physical and emotional well-being and gastric cancer subscales were recovered or improved after the PRER-GC (all p<0.05). Depression remain unchanged, while fatigue was decreased at T3 (50.33 ± 7.0) as compared to T1 (68.00 ± 8.4) and T2 (78.00 ± 9.7) assessed by CES-D (p<0.05). There were no statistical differences in inflammatory markers between those GC patients with and without the PREP-GC. CONCLUSION: Our results indicate that the combination of aerobic and resistance exercise was effective to improve muscle mass and physical and emotional well-being in gastric cancer patients after the gastrectomy.