Abstract
BackgroundThe physical activity (PA) level of patients undergoing major cancer surgery remains unclear. This pilot study aimed to: (i) Compare preoperative PA level between patients undergoing major cancer surgery and the general population; (ii) describe PA trajectories following major cancer surgery; (iii) Compare objective versus subjective PA measures in patients undergoing major cancer surgery; and (iv) Investigate the association between preoperative PA level and postoperative outcomes.MethodsPatients undergoing pelvic exenteration between September/2016 and September/2017 were included and followed at preoperative, 6-weeks and 6-months postoperative. PA was measured using the International Physical Activity Questionnaire Short-Form and McRoberts activity monitor. Analyses were performed using SPSS.ResultsThis pilot study included 16 patients. When compared to the general population, patients undergoing major cancer surgery presented a reduced preoperative PA level. PA levels decreased at 6 weeks but returned to preoperative levels at 6 months postoperative. Objective and subjective measures of PA were comparable, with some variables presenting strong correlations. A higher preoperative level PA was associated with an absence of postoperative complications and better quality of life outcomes.ConclusionsPatients undergoing major cancer surgery demonstrated lower PA levels when compared to the general population. PA trajectories decreased at 6 weeks postoperative, returning to preoperative levels within 6-months. In this cohort, it seems that higher preoperative PA level may improve postoperative surgical outcomes; however, this preliminary evidence should be confirmed in a larger cohort.
Highlights
The physical activity (PA) level of patients undergoing major cancer surgery remains unclear
Our study showed that patients who are about to undergo major surgery for locally advanced or recurrent cancer within the pelvis were less physically active than the general Australian population
We found that higher levels of vigorous PA preoperatively were significantly associated with a decrease in postoperative complications and better postoperative quality of life outcomes
Summary
The physical activity (PA) level of patients undergoing major cancer surgery remains unclear. A systematic review [8] of 10 cohort studies demonstrated that patients with breast, colon and rectal cancer who engaged in higher levels of PA had increased survival rates. A prospective cohort study involving 220 patients evaluated the association between the preoperative levels of PA and recovery after breast cancer surgery. Patients who presented with higher preoperative PA levels had a faster recovery in the short-term (RR = 1.85 [95%CI = 1.20 to 2.85]) [10]. Another cohort study that included 200 patients undergoing elective cholecystectomy due to gallstone disease, investigated the effects of preoperative PA on postoperative recovery and complication rates. Regular PA participation in the preoperative period was found to be associated with better recovery and fewer complications following cholecystectomy [11]
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