B-004DOES SHORT-TERM PREOPERATIVE EXERCISE THERAPY INFLUENCE LONG-TERM LUNG FUNCTIONAL OUTCOME FOLLOWING LUNG CANCER SURGERY?

Abstract

Objectives: Exercise-based rehabilitation programs have been shown to improve both aerobic fitness and quality of life among cancer patients. So far, the long-term functional impact of preoperative exercise intervention has not been examined in patients awaiting lung cancer surgery. The aim of this study was to evaluate the effectiveness of a high-intensity training (HIT) program on postoperative functional outcome. Methods: Randomized controlled trial, two centres patients scheduled to undergo lung cancer resection were randomized into usual care or rehabilitation arm (UC and Rehab groups). Preoperative rehabilitation was conducted by physiotherapists and consisted in 2 to 3 HIT sessions per week. Postoperative clinical outcome data included postoperative mortality, lung volume, lung diffusion capacity and aerobic fitness parameters (peak oxygen uptake [VO2peak], and maximal work [Wmax]). To analyze the impact of treatment and time, Student t-test, Mann-Whitney or Wilcoxon U-tests, the Pearson χ2 test and ANOVAwere used. Results: Over a 3-year period, a total of 189 patients were screened, and 151 were analyzed (N = 77 in UC group and N = 74 in Rehab group). Groups were comparable. The median time delay from enrollment to surgery was 26 days (interquartile 25-75%, 21-33 days). The HIT program prevented the impairment in aerobic fitness parameters in rehabilitated patients before surgery as reflected by significant increases in VO2peak (median +15% [IQ 25-75, +9 to +22%]) and in maximal power (median +6% [IQ 25-75, 0 to +17%]). At one year following lung cancer surgery, there was no significant difference between the two groups regarding mortality rate (9.1% in UC group vs 6.8% in Rehab group), lung pulmonary function tests and aerobic fitness parameters. Conclusion: This study indicates that preparing patients with a HIT program enhanced aerobic fitness parameters before surgery but failed to improve survival and functional parameters one year following lung cancer surgery.