Rongali Velangani Bhavya Swetha, Knight Joanne, Banfield Chloe, Korompelis Porfyrios, Rundle Stuart, Smits Anke
Northern Gynecological Oncology Centre, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK.
Department of Anaesthetics, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK.
Cancers (Basel). 2025 Apr 26;17(9):1460. doi: 10.3390/cancers17091460.
Preoperative cardiopulmonary exercise testing (CPET) provides an objective measure of a patient's functional capacity under stress. However, the association between CPET and long-term outcomes for women with ovarian cancer have not been assessed. The aim was to determine whether cardiorespiratory fitness, as measured by CPET parameters-peak oxygen uptake (VO peak), ventilatory efficiency at anaerobic threshold (VE/VCO at AT), and anaerobic threshold (AT)-could predict overall survival (OS) and recurrence -free survival (RFS) in patients with all stages of ovarian cancer.
This was a retrospective cohort study of patients who underwent CPET prior to surgery for suspected or confirmed ovarian cancer during 2019-2023 at the Northern Gynaecological Oncology Centre, United Kingdom. CPET outcomes were risk-stratified, with thresholds of AT ≥ 10 mL/min, VO peak ≥ 15 mL/kg/min, and VE/VCO at AT ≤ 34 indicating lower risk. Primary outcomes included OS and RFS.
A total of 303 patients were included, of whom 56 (18.5%) had a staging laparotomy, 130 (42.9%) underwent primary cytoreductive surgery, and 117 (38.6%) underwent interval cytoreductive surgery. Survival analysis showed that VO peak ≥ 15 was significantly associated with improved OS of the whole population ( = 0.032). VE/VCO at AT ≤ 34 was associated with improved survival in patients with advanced stage disease ( = 0.025) after ovarian cancer surgery. There was no association between CPET parameters and RFS.
We found that peak VO ≥ 15 was associated with improvement of overall survival in patients with all stages of ovarian cancer. In addition, VE/VCO at AT ≤ 34 was associated with overall survival in patients with advanced-stage disease.
术前心肺运动试验（CPET）可客观衡量患者在应激状态下的功能能力。然而，CPET与卵巢癌女性患者长期预后之间的关联尚未得到评估。本研究旨在确定通过CPET参数——峰值摄氧量（VO₂峰值）、无氧阈时的通气效率（无氧阈时的VE/VCO₂）和无氧阈（AT）所衡量的心肺适能，是否能够预测各期卵巢癌患者的总生存期（OS）和无复发生存期（RFS）。
这是一项回顾性队列研究，研究对象为2019年至2023年期间在英国北部妇科肿瘤中心因疑似或确诊卵巢癌而接受手术前CPET检查的患者。CPET结果按风险分层，AT≥10 mL/min、VO₂峰值≥15 mL/kg/min和无氧阈时的VE/VCO₂≤34为低风险阈值。主要结局包括OS和RFS。
共纳入303例患者，其中56例（18.5%）接受了分期剖腹探查术，130例（42.9%）接受了初次肿瘤细胞减灭术，117例（38.6%）接受了中间性肿瘤细胞减灭术。生存分析显示，VO₂峰值≥15与总体人群的OS改善显著相关（P = 0.）。无氧阈时的VE/VCO₂≤34与卵巢癌手术后晚期疾病患者的生存改善相关（P = 0.025）。CPET参数与RFS之间无关联。
我们发现VO₂峰值≥15与各期卵巢癌患者的总生存期改善相关。此外，无氧阈时的VE/VCO₂≤34与晚期疾病患者的总生存期相关。
