Hamad Ahmad, Zhang Hongji, Zhang Yunwei, Shen Chengli, Fa Pengyan, Huang Hai, Ejaz Aslam, Tsung Allan
Department of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA.
Department of Surgery, University of Virginia School of Medicine, P O Box 800709, Charlottesville, VA, 22908, USA.
BMC Sports Sci Med Rehabil. 2025 Mar 14;17(1):50. doi: 10.1186/s13102-025-01094-6.
There is a gap in knowledge regarding the utility of preoperative exercise (PEx) among gastrointestinal (GI) cancer patients undergoing surgery and how PEx impacts surgical outcomes. This study seeks to evaluate the mechanism behind PEx among patients undergoing major abdominal surgery for GI cancer through a randomized controlled trial (RCT).
This was a single center RCT conducted at The Ohio State University Wexner Medical Center. Eligible patients diagnosed with GI cancers with planned abdominal surgery were randomized to receive PEx or a Sedentary (Non-PEx) arm between October 2020 and May 2022. To investigate if PEx could lead to systemic change in circulation, we employed secretomics and metabolomics analyses of patient serum samples before and after exercise to detect inflammatory and tumorigenic responses, with the primary endpoint of investigating the mechanisms through which PEx modulates the inflammatory response in patients undergoing GI cancer surgery.
Between October 2020 and May 2022, 64 patients were enrolled in the study, with 28 randomized to the PEx group and 36 to the non-PEx group. The two cohorts were comparable in terms of age, gender, and comorbidity burden. The median length of stay was 6 days across the entire cohort, with no significant differences between the groups. Similarly, the overall 30-day readmission rate was 15.7%, and the median comprehensive complication index score was 20.9, both of which showed no differences between the PEx and non-PEx groups. Secretomics and metabolomics analyses of patient serum samples revealed a shift towards an anti-inflammatory and anti-tumorigenic phenotype, with significant changes in secretion and metabolic profiles observed in post-PEx serum compared to pre-PEx serum from the same patients.
PEx has the potential to mitigate the pro-inflammatory and pro-tumorigenic state of GI cancer by modulating specific cellular pathways. This study provides evidence into the mechanisms underlying these effects, but additional research is required to explore their applicability in therapeutic development. These findings build upon existing research to support the advancement of exercise-inspired therapeutic strategies in the future.
The trial was registered at Clinicaltrials.gov (NCT04602026) on 20/10/2020.
在接受手术的胃肠道（GI）癌症患者中，关于术前运动（PEx）的效用以及PEx如何影响手术结果，存在知识空白。本研究旨在通过一项随机对照试验（RCT）评估接受胃肠道癌症大手术患者进行PEx的潜在机制。
这是一项在俄亥俄州立大学韦克斯纳医学中心进行的单中心RCT。2020年10月至2022年5月期间，将计划接受腹部手术的确诊胃肠道癌症患者随机分为接受PEx组或久坐（非PEx）组。为了研究PEx是否会导致循环系统的全身性变化，我们对患者运动前后的血清样本进行了分泌组学和代谢组学分析，以检测炎症和致瘤反应，主要终点是研究PEx调节胃肠道癌症手术患者炎症反应的机制。
2020年10月至2022年5月期间，64例患者纳入本研究，28例随机分配至PEx组，36例分配至非PEx组。两组在年龄、性别和合并症负担方面具有可比性。整个队列的中位住院时间为6天，两组之间无显著差异。同样，30天再入院率总体为15.7%，中位综合并发症指数评分为20.9，PEx组和非PEx组之间均无差异。对患者血清样本的分泌组学和代谢组学分析显示，向抗炎和抗肿瘤表型转变，与同一患者运动前血清相比，运动后血清的分泌和代谢谱有显著变化。
PEx有可能通过调节特定细胞途径减轻胃肠道癌症的促炎和促瘤状态。本研究为这些作用的潜在机制提供了证据，但需要更多研究来探索其在治疗开发中的适用性。这些发现基于现有研究，以支持未来运动启发治疗策略的发展。
该试验于2020年10月20日在Clinicaltrials.gov（NCT04602026）注册。
