Effects of a multimodal rehabilitation programme on inflammation and oxidative stress in oesophageal cancer survivors: the ReStOre feasibility study

Guinan, Emer; Doyle, Suzanne; O’Neill, Linda; Dunne, Margaret R.; Foley, Emma; O’Sullivan, Jacintha; Reynolds, John V.; Hussey, Juliette

doi:10.1007/s00520-016-3455-0

Cited by 34 publications

(46 citation statements)

References 45 publications

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“…The CROSS study established a modern benchmark, achieving a 47 per cent 5‐year survival rate among patients with locally advanced disease treated with multimodal therapy. With such welcome advances with respect to oncological outcome, there is increasingly a focus on functional recovery and health‐related quality of life (HR‐QoL) in survivorship, as the attritional impact of oesophagectomy is widely appreciated.…”

Section: Introductionmentioning

confidence: 99%

Changes in gut hormones, glycaemic response and symptoms after oesophagectomy

Elliott

Docherty

Murphy

et al. 2019

British Journal of Surgery

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Background: Oesophagectomy is associated with reduced appetite, weight loss and postprandial hypoglycaemia, the pathophysiological basis of which remains largely unexplored. This study aimed to investigate changes in enteroendocrine function after oesophagectomy.Methods: In this prospective study, 12 consecutive patients undergoing oesophagectomy were studied before and 10 days, 6, 12 and 52 weeks after surgery. Serial plasma total fasting ghrelin, and glucagon-like peptide 1 (GLP-1), insulin and glucose release following a standard 400-kcal mixed-meal stimulus were determined. CT body composition and anthropometry were assessed, and symptom scores calculated using European Organisation for Research and Treatment of Cancer (EORTC) questionnaires. Results: At 1 year, two of the 12 patients exhibited postprandial hypoglycaemia, with reductions in bodyweight (mean(s.e.m.) 17⋅1(3⋅2) per cent, P < 0⋅001), fat mass (21.5(2.5) kg versus 25.5(2.4) kg before surgery; P = 0⋅014), lean body mass (51.5(2.2) versus 54.0(1.8) kg respectively; P = 0⋅003) and insulin resistance (HOMA-IR: 0.84(0.17) versus 1.16(0.20); P = 0⋅022). Mean(s.e.m.) fasting ghrelin levels decreased from postoperative day 10, but had recovered by 1 year (preoperative: 621⋅5(71⋅7) pg/ml; 10 days: 415⋅1(59⋅80) pg/ml; 6 weeks: 309⋅0(42⋅0) pg/ml; 12 weeks: 415⋅8(52⋅1) pg/ml; 52 weeks: 547⋅4(83⋅2) pg/ml; P < 0⋅001) and did not predict weight loss (P = 0⋅198). Postprandial insulin increased progressively at 10 days, 6, 12 and 52 weeks (mean(s.e.m.) insulin AUC 0-30 min : fold change 1⋅7(0⋅4), 2⋅0(0⋅4), 3⋅5(0⋅7) and 4⋅0(0⋅8) respectively; P = 0⋅001). Postprandial GLP-1 concentration increased from day 10 after surgery (P < 0⋅001), with a 3⋅3(1⋅8)-fold increase at 1 year (P < 0⋅001). Peak GLP-1 level was inversely associated with the postprandial glucose nadir (P = 0⋅041) and symptomatic neuroglycopenia (Sigstad score, P = 0⋅017, R 2 = 0⋅45). GLP-1 AUC predicted loss of weight (P = 0⋅008, R 2 = 0⋅52) and fat mass (P = 0⋅010, R 2 = 0⋅64) at 1 year.Conclusion: Altered enteroendocrine physiology is associated with early satiety, weight loss and postprandial hypoglycaemia after oesophagectomy.

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Section: Introductionmentioning

confidence: 99%

Changes in gut hormones, glycaemic response and symptoms after oesophagectomy

Elliott

Docherty

Murphy

et al. 2019

British Journal of Surgery

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“…Exercise prehabilitation may be useful in exposing participants to similar cardiovascular stresses associated with surgery and therefore increase their readiness for the surgery (Plowman & Smith 2013). Exercise also has been proven to have ant-inflammatory effects (Gleeson et al 2011, Guinan et al 2017 and again may be useful in reducing overall bodily inflammation pre-surgery as Physical function performance and recovery of patients undergoing abdominal surgery in relation to complications -A prospective real world study -120 -surgical stress will invoke an inflammatory response, as previously discussed in section 1.1.2 (Scott & Miller 2015, Fnnerty et al 2015. What may be helpful in relation to this study in linking it with exercise prehabilitation, would be to use the IPAQ as a measurement tool and determine if advice regarding increasing activity preoperatively has an effect and if so to what extent.…”

Section: Exercise Prehabilitationmentioning

confidence: 99%

Physical function performance and recovery of patients undergoing abdominal surgery in relation to post-operative complications–A prospective real world study

Flahive¹,

Driscoll²,

Broderick³

2018

Physiotherapists

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Objective: The primary aim of the study is to evaluate the physical function performance differences between those who develop complications and those who do not and determine their impact on recovery. Background: Complication rates in abdominal (colorectal, hernia repair & cholecystectomies) surgery are variable and appear to be lower in minimally invasive, less complex surgery. Complications are associated with significant costs in terms of morbidity, finance, psychological and impact on recovery. Factors that have been identified as associated with complications include age, BMI, surgical approach, co-morbidities, American Society of Anaesthesiologists (ASA) status, physical function frailty and level of dependency. It is also clear that these factors individually are unlikely predictors but highlight the need for multifactorial assessment. Surgical procedures in their essence cause significant physiological stress which can often mimic similar physiological effects of exercise. Cardiopulmonary exercise testing (CPET) can be useful in predicting complications, however is generally unavailable and not always suitable. No one measure has been identified to predict complications in an abdominal surgery population, hence the need to evaluate physical function performance as a whole and analyse differences that may emerge between those who develop complications and those who do not. Methods: Participants were recruited (n = 49) via the pre-operative assessment unit in the University Hospital Limerick. Pre-operative assessment included the following: demographics data, six-minute walk distance, VO2Peak, spirometry, peak cough flow, self-reported activity using the International Physical Activity Questionnaire (IPAQ), ASA score, surgical Physical function performance and recovery of patients undergoing abdominal surgery in relation to complications-A prospective real world study-4-grade, Malnutrition Universal Scoring Tool (MUST) score, albumin and creatinine levels. Post-surgery data included surgery type, length, surgical approach, initial 24-hour pain relief, length of stay and complications. At 30 and 60 days, participants were contact via telephone and the telephone IPAQ repeated, questioned regarding their self-assessed physical recovery and post hospital discharge complications. Results: Surgery types fell into the following 4 categories: colorectal (n = 21), colorectal reversals (n = 7), hernia repairs (n = 10) and cholecystectomies (n = 5). The complications rate was 41.9% (n=18) pre-discharge, 30.2% (n=13) at 30 day's post-surgery and 21% (n = 9) at 60 day's post-surgery. Obesity (P=0.005*), longer operating time (P=0.05*), >2 co-morbidities (P = 0.033*), low activity levels (P=0.020*), low VO2Peak (P=0.017*) and lower 6-minute walk distance (P=0019*) were statistically different between complications and non-complications groups with worse scores seen in the complications group. Length of stay was significantly increased in the complications groups at a median of 8.5 nights versus 2 nights in the non-compl...

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“…Different studies implicate that oxidative stress plays a pivotal role in the onset and/or progression of many different pathologies including cardiovascular diseases,1 2 cancers,3–5 neurodegenerative,6–8 metabolic,9 10 pregnancy complications11 12 and inflammatory diseases 11–14. Nowadays, oxidative stress has become a major interest of clinical and basic science research.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effect of resveratrol supplementation on oxidative stress: a systematic review and meta-analysis of randomised controlled trials

Lakzaei

Khodabandehloo

Hosseini

et al. 2019

Postgraduate Medical Journal

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BackgroundResveratrol is a naturally occurring polyphenol compound mainly found in grapes and red wine. The evidence has suggested that resveratrol has an antioxidant effect. However, the results are inconsistent and inconclusive. Thus, we conducted a systematic review and meta-analysis to evaluate the effect of resveratrol supplementation on markers of oxidative stress.MethodsWe searched PubMed, ISI Web of Science, EMBASE, Scopus and the Cochrane library up to December 2018 to identify randomised controlled trials (RCTs) assessing resveratrol supplementation effects on oxidative markers. Heterogeneity, publication bias, risk of bias and subgroup analysis were analysed. This meta-analysis was conducted in accordance with the guidelines of the Preferred ReportingItems for Systematic Reviews and Meta-Analysis (PRISMA).ResultsMeta-analysis of data from 12 RCTs did not support significant effect of resveratrol supplementation on circulating levels of superoxide dismutase (SOD) (standardized mean difference (SMD) (1.12), (95% CI −0.91 to 3.1), p=0.28), catalase (CAT) (SMD (−0.07), (95% CI −1.4 to 1.3), p=0.92) and glutathione peroxidase (GPx) (SMD (−0.76), (95% CI −2.56 to 1.04), p=0.40). Although, resveratrol supplementation increased significantly circulating total antioxidant capacity (TAC) concentrations (SMD (0.52), (95% CI −0.02 to 1.07), p=0.05). Severe heterogeneity was observed between studies, and no obvious publication bias was observed in included RCTs.ConclusionCollectively, our findings of available RCTs did no show any benefit of resveratrol supplementation on SOD, CAT and GPx except for TAC. Well-designed RCTs are necessary to confirm these results.

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Effects of a multimodal rehabilitation programme on inflammation and oxidative stress in oesophageal cancer survivors: the ReStOre feasibility study

Abstract: Results suggest that multimodal rehabilitation following OC treatment reduced inflammatory status without compromising body composition. Findings will be further examined in a larger randomised controlled trial.

Cited by 34 publications

References 45 publications

Changes in gut hormones, glycaemic response and symptoms after oesophagectomy

Changes in gut hormones, glycaemic response and symptoms after oesophagectomy

Physical function performance and recovery of patients undergoing abdominal surgery in relation to post-operative complications–A prospective real world study

Therapeutic effect of resveratrol supplementation on oxidative stress: a systematic review and meta-analysis of randomised controlled trials

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