Physiologic Status of Oncology Patients Awaiting Abdominal Surgery

Abstract

PURPOSE: Increasingly exercise training is being used as a non-pharmacologic therapeutic intervention to reduce the effects of both the disease and the treatment. While these patients benefit from exercise training, little is known about their physiologic status. Such information is needed to maximize the effectiveness of exercise training. Therefore, this study sought to determine the safety and feasibility of using cardiopulmonary exercise testing (CPET) application in an oncology patient population. METHODS: After receiving physician clearance, 130 subjects (100 males, 30 females) with abdominal, gastrointestinal and urinary tract tumors underwent a standard ramp bicycle ergometer CPET 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. CPET parameters were analyzed by Harbor-UCLA standard methods. Tests were symptom limited. This protocol was approved by the UT MD Anderson Cancer Center Institutional Review Board. RESULTS: Subjects age (mean + SD) was 58.9 + 12.7 yrs. and their BMI was 29.0 + 6.25. Peak VO2 averaged 19.8 + 6.1 ml·kg−1·min−1 or 78.7% of predicted peak VO2. Heart rate (141 + 24 BPM) at peak work load (120 + 51 W) averaged 87% of age predicted peak heart rate. Mean respiratory exchange rate at peak VO2 was 1.2 + 0.1. No adverse events occurred during testing. CONCLUSIONS: This oncology patient population appears able to tolerate and safely complete a symptom limited CPET. Results suggest that this patient population is less fit than age-matched healthy individuals which may put them at greater risk for adverse surgical outcomes.