Güney Beyzanur, Alomari Omar, Mokresh Muhammed Edib, Eyvazova Habiba, Ari Elif Nur, Yegin Rumeysa, Ertan Sinem Nur, Nabiyeva Zeynab, Nurnazarov Atajan, Odabas Hatice
Hamidiye International School of Medicine, University of Health Sciences, 34668, Istanbul, Turkey.
Hamidiye School of Medicine, University of Health Sciences, Istanbul, Turkey.
Support Care Cancer. 2025 Jun 26;33(7):629. doi: 10.1007/s00520-025-09692-3.
BACKGROUND/AIM: Bladder cancer is among the most common malignancies, often treated with radical cystectomy (RC) for muscle-invasive cases. However, RC is associated with high postoperative complication rates. Preoperative and postoperative exercise programs have been proposed to enhance recovery and quality of life (QoL) in bladder cancer patients. This systematic review aims to evaluate the impact of exercise interventions on QoL in patients undergoing cystectomy.
A systematic review was conducted following PRISMA 2020 guidelines and registered with PROSPERO (CRD42024623205). A comprehensive search across Web of Science, PubMed, Scopus, and Cochrane databases identified studies on exercise interventions in cystectomy patients. Eligibility criteria included randomized controlled trials, cohort studies, and case reports involving bladder cancer patients undergoing pre- or postoperative exercise. Data were analyzed using R version 4.3.1, applying random-effects models to calculate mean differences (MDs) and 95% confidence intervals (CIs). Heterogeneity was assessed using τ, I, and Q-tests.
Ten studies (n = 564) met the inclusion criteria. Meta-analysis revealed that preoperative exercise significantly improved postoperative QoL scores (standardized mean difference [SMD] = 0.62; 95% confidence interval [CI]: 0.44-0.80; p < 0.001; I = 22%). Postoperative exercise also enhanced cardiorespiratory function and reduced postoperative complications (SMD = 0.48; 95% CI: 0.32-0.64; p < 0.001; I = 18%). Combined pre- and postoperative exercise yielded the highest QoL improvements.
Exercise programs significantly enhance QoL in bladder cancer patients undergoing cystectomy by reducing complications and improving physical and emotional resilience. However, high heterogeneity, inconsistent outcome measures, and limited statistically significant effects in some domains highlight the need for standardized protocols and further high-quality research.
背景/目的：膀胱癌是最常见的恶性肿瘤之一，对于肌肉浸润性病例通常采用根治性膀胱切除术（RC）进行治疗。然而，RC与较高的术后并发症发生率相关。术前和术后运动方案已被提出，以促进膀胱癌患者的恢复并提高生活质量（QoL）。本系统评价旨在评估运动干预对接受膀胱切除术患者生活质量的影响。
按照PRISMA 2020指南进行系统评价，并在PROSPERO（CRD42024623205）注册。在Web of Science、PubMed、Scopus和Cochrane数据库中进行全面检索，以确定关于膀胱切除术患者运动干预的研究。纳入标准包括随机对照试验、队列研究以及涉及接受术前或术后运动的膀胱癌患者的病例报告。使用R版本4.3.1进行数据分析，应用随机效应模型计算平均差（MDs）和95%置信区间（CIs）。使用τ、I和Q检验评估异质性。
10项研究（n = 564）符合纳入标准。荟萃分析显示，术前运动显著改善术后生活质量评分（标准化平均差[SMD] = 0.62；95%置信区间[CI]：0.44 - 0.80；p < 0.001；I = 22%）。术后运动还增强了心肺功能并减少了术后并发症（SMD = 0.48；95% CI：0.32 - 0.64；p < 0.001；I = 18%）。术前和术后联合运动使生活质量改善最为显著。
运动方案通过减少并发症以及改善身体和情绪恢复力，显著提高了接受膀胱切除术的膀胱癌患者的生活质量。然而，高异质性、不一致的结局测量以及某些领域有限的统计学显著效果凸显了标准化方案和进一步高质量研究的必要性。
