Impact of curative treatment on the physical fitness of patients with esophageal cancer: A systematic review and meta-analysis
Reijneveld, Elja A E; Bor, Petra; Dronkers, Jaap J; Argudo, Núria; Ruurda, Jelle P; Veenhof, Cindy
(2022) European Journal of Surgical Oncology, volume 48, issue 2, pp. 391 - 402
(Article)
Abstract
BACKGROUND: Esophageal cancer and curative treatment have a significant impact on the physical fitness of patients. Knowledge about the course of physical fitness during neoadjuvant therapy and esophagectomy is helpful to determine the needs for interventions during and after curative treatment. This study aims to review the current evidence on
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the impact of curative treatment on the physical fitness of patients with esophageal cancer. METHODS: A systematic literature search of PubMed, Embase, Cinahl and the Cochrane Library was conducted up to March 29, 2021. We included observational studies investigating the change of physical fitness (including exercise capacity, muscle strength, physical activity and activities of daily living) from pre-to post-neoadjuvant therapy and/or from pre-to post-esophagectomy. Quality of the studies was assessed and a meta-analysis was performed using standardized mean differences. RESULTS: Twenty-seven articles were included. After neoadjuvant therapy, physical fitness decreased significantly. In the first three months after surgery, physical fitness was also significantly decreased compared to preoperative values. Subgroup analysis showed a restore in exercise capacity three months after surgery in patients who followed an exercise program. Six months after surgery, there was limited evidence that exercise capacity restored to preoperative values. CONCLUSION: Curative treatment seems to result in a decrease of physical fitness in patients with esophageal cancer, up to three months postoperatively. Six months postoperatively, results were conflicting. In patients who followed a pre- or postoperative exercise program, the postoperative impact of curative treatment seems to be less.
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Keywords: Curative treatment, Esophageal cancer, Physical fitness, Physiotherapy, Oncology, Surgery, Review, Journal Article
ISSN: 0748-7983
Publisher: W.B. Saunders Ltd
Note: Funding Information: We express our gratitude to all authors of the included studies for providing additional information and/or data from their studies (W.A. Allum, Royal Marsden Hospital, UK; G.A. von Döbeln, Karolinska University Hospital, Sweden; M.A. van Egmond, Amsterdam University of Applied Sciences, the Netherlands; M. Fagevik-Olsén, Sahlgrenska University Hospital, Sweden; E.M. Guinan, Trinity College Dublin, Ireland; H. Ichikawa, Niigata University, Japan; I. Lidoriki, Laikon Hospital of Athens, Greece; E. Piraux, Catholic University of Louvain, Belgium; N. Tatematsu, Nagoya University, Japan). Publisher Copyright: © 2021 The Authors
(Peer reviewed)