Feasibility and Effects of a Postoperative Recovery Exercise Program Developed Specifically for Gastric Cancer Patients (PREP-GC) Undergoing Minimally Invasive Gastrectomy

Abstract

PurposeExercise intervention after surgery has been found to improve physical fitness and quality of life (QOL). The purpose of this study was to investigate the feasibility and effects of a postoperative recovery exercise program developed specifically for gastric cancer patients (PREP-GC) undergoing minimally invasive gastrectomy.Materials and MethodsTwenty-four patients treated surgically for early gastric cancer were enrolled in the PREP-GC. The exercise program comprised sessions of In-hospital Exercise (1 week), Home Exercise (1 week), and Fitness Improvement Exercise (8 weeks). Adherence and compliance to PREP-GC were evaluated. In addition, body composition, physical fitness, and QOL were assessed during the preoperative period, after the postoperative recovery (2 weeks after surgery), and upon completing the PREP-GC (10 weeks after surgery).ResultsOf the 24 enrolled patients, 20 completed the study without any adverse events related to the PREP-GC. Adherence and compliance rates to the Fitness Improvement Exercise were 79.4% and 99.4%, respectively. Upon completing the PREP-GC, patients also exhibited restored cardiopulmonary function and muscular strength, with improved muscular endurance and flexibility (P<0.05). Compared to those in the preoperative period, no differences were found in symptom scale scores measured using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Quality of Life Questionnaire-Stomach Cancer-Specific Module (QLQ-STO22); however, higher scores for global health status and emotional functioning were observed after completing the PREP-GC (P<0.05).ConclusionsIn gastric cancer patients undergoing minimally invasive gastrectomy, PREP-GC was found to be feasible and safe, with high adherence and compliance. Although randomized studies evaluating the benefits of exercise intervention during postoperative recovery are needed, surgeons should encourage patients to participate in systematic exercise intervention programs in the early postoperative period (Registered at the ClinicalTrials.gov NCT01751880).

Identifying outcomes reported in exercise interventions in oesophagogastric cancer survivors: a systematic review

“…The study characteristics of the six included studies are outlined in Table 1 . The included studies comprise three randomised control trials (RCTs) [ 5 , 6 , 24 ], two single arm feasibility studies [ 21 – 23 ], and one protocol for an RCT [ 25 ]. All included studies were published between 2017 and 2020.…”

“…Four of the studies included participants who had oesophageal cancer only [ 6 , 21 , 22 , 24 , 25 ], one study included participants who had gastric cancer only [ 23 ], and one study included participants who had either oesophageal, oesophageal junction, or gastric cancers [ 5 ]. Surgery was used as a treatment technique in all studies.…”

“…In addition to the core EORTC-QLQ-C30 questionnaire [ 28 ], Chang et al [ 6 ] and the ReStOre feasibility study [ 21 , 22 ] used the oesophageal-specific module (QLQ-OES18) [ 29 ]. Cho et al [ 23 ] used the gastric-specific cancer module (QLQ-STO22) [ 30 ] and Van Vulpen et al [ 25 ] planned to use the oesophagogastric-specific module (QLQ-OG25) [ 31 ]. The site-specific modules take into consideration any symptoms relating specifically to upper gastrointestinal symptoms, to include xerostomia, ageusia, dysphagia, choking, indigestion, and pain on eating or drinking.…”

“…Exercise capacity, fitness and/or physical function refer to an individual’s ability to undertake exercise and physical tasks of everyday living [ 39 ] and were measured or planned to be measured in all studies. Five studies measured or planned to measure exercise capacity using maximal cardiopulmonary exercise tests (CPETs) [ 5 , 6 , 21 – 23 , 25 ]. In addition to CPETs, Chang et al [ 6 ] and The ReStOre feasibility study [ 21 , 22 ] measured functional capacity using the distance mobilised in the Six-Minute Walk Test [ 40 ].…”

Factors associated with fatigue one month after surgery in patients with gastrointestinal cancer

“…A mong cancer patients, rehabilitation is widely performed from the prevention period to the palliative period 1) . Early intervention is important to improve the physical function and quality of life (QOL) after surgery 2) . However, there are patients whose physical function and QOL decline because of cancer-related symptoms before and after cancer treatment, and fatigue is one of the symptoms [3][4][5] .…”