Ibilibor Christine, Weeldreyer Nathan R, Angadi Siddhartha S
Division of Urologic Oncology, Department of Urology, University of Virginia, Charlottesville, VA, USA.
Department of Kinesiology, University of Virginia, Charlottesville, VA, USA.
Support Care Cancer. 2025 Jun 9;33(7):558. doi: 10.1007/s00520-025-09611-6.
To evaluate the potential impact of perioperative exercise on survival and post-operative mortality in oncologic patients undergoing surgical resection.
A systematic review of randomized controlled trials administering perioperative exercise in oncologic patients undergoing surgical resection published between 2000 and 2024 was performed. Embase, PubMed, Web of Science, and the Cochrane Library were searched, and outcomes of interest included recurrence-free survival, disease-free survival, cancer-specific survival, overall survival, or post-operative mortality.
Of the 806 articles identified, 5 met inclusion criteria, representing 650 oncologic patients receiving pulmonary (n = 2), hepatobiliary (n = 1), gastroesophageal (n = 1), and colorectal surgeries (n = 1). Of the 650 patients, 330 were randomized to a perioperative exercise intervention. Perioperative exercise was generally administered pre-operatively (n = 4), ranged in duration from 2 weeks (n = 1) to 3 months (n = 1) and ranged from low (n = 1) to high (n = 1) intensity. The types of exercise regimens included walking (n = 5), cycling (n = 4), or jogging (n = 2) either alone or in combination with nutritional and psychosocial support. In all studies, perioperative exercise improved indices of cardiorespiratory fitness. However, perioperative exercise improved disease-free survival in only one study, and post-operative mortality did not differ between perioperative exercise and control groups.
In the reviewed studies, the use of perioperative exercise enhanced physical fitness, but did not show a significant effect on post-operative mortality. However, survival was the primary endpoint for only one of the included studies and the type of exercise regimen varied widely. Thus, our findings are limited by its sample size and highlight the lack of uniformity in perioperative exercise regimens and the need for future trials to be powered to determine the effect of exercise on long-term oncologic endpoints.
评估围手术期运动对接受手术切除的肿瘤患者生存及术后死亡率的潜在影响。
对2000年至2024年期间发表的关于对接受手术切除的肿瘤患者进行围手术期运动的随机对照试验进行系统评价。检索了Embase、PubMed、科学引文索引和考克兰图书馆，感兴趣的结果包括无复发生存期、无病生存期、癌症特异性生存期、总生存期或术后死亡率。
在检索到的806篇文章中，5篇符合纳入标准，代表650例接受肺部手术（n = 2）、肝胆手术（n = 1）、胃食管手术（n = 1）和结直肠手术（n = 1）的肿瘤患者。在这650例患者中，330例被随机分配至围手术期运动干预组。围手术期运动通常在术前进行（n = 4），持续时间从2周（n = 1）至3个月（n = 1）不等，强度从低（n = 1）至高（n = 1）不等。运动方案的类型包括单独的步行（n = 5）、骑自行车（n = 4）或慢跑（n = 2），或与营养和心理社会支持相结合。在所有研究中，围手术期运动改善了心肺适能指标。然而，仅在一项研究中围手术期运动改善了无病生存期，围手术期运动组与对照组之间的术后死亡率无差异。
在纳入评价的研究中，围手术期运动的使用增强了身体素质，但对术后死亡率未显示出显著影响。然而，生存仅为其中一项纳入研究的主要终点，且运动方案的类型差异很大。因此，我们的研究结果受样本量限制，突出了围手术期运动方案缺乏一致性，以及未来试验需要有足够的效力来确定运动对长期肿瘤学终点的影响。
