Vigorous cardiovascular activity and improvement of cardiopulmonary fitness before surgery may improve postoperative outcomes and recovery for patients with bladder cancer, according to a study published in Supportive Care in Cancer.
Evidence from previous studies suggest that preoperative cardiopulmonary fitness may be associated with outcomes, but there is a lack of data that explores the implications of increasing cardiopulmonary fitness prior to surgery in order to improve outcomes.
For this feasibility study, 60 patients with bladder cancer who completed a cardiopulmonary exercise test (CPET) were randomly assigned to an exercise arm or control arm. The exercise arm participated in preoperative vigorous intensity aerobic exercises twice weekly in addition to standard therapy, while the control arm received only standard therapy. The CPET was given again prior to surgery, and postoperative recovery outcomes were recorded.
Patients in the exercise arm completed a median of 8 exercise sessions over 3 to 6 weeks prior to surgery. CPET results for patients in the exercise arm before surgery revealed improvements in oxygen pulse peak values (P =.001), minute ventilation (P =.002), and power output (P <.001).
Although this study was not adequately powered to truly explore the effect exercise would have on postoperative recovery, investigators observed that patients in the exercise arm trended favorably towards the need for high dependency unit inotropic support and postoperative Clavien-Dindo score.
Vigorous exercise intended to improve cardiopulmonary fitness among patients with bladder cancer preoperatively was feasible, leading the authors to conclude that “[t]hese findings provide a strong foundation for an adequately powered randomized controlled trial.”
Banerjee S, Manley K, Shaw B, et al. Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial [published online November 27, 2017]. Support Care Cancer. doi: 10.1007/s00520-017-3991-2