Surgical resection of primary tumour improves aerobic performance in colorectal cancer

Williams, John P.; Nyasavajjala, Sitaramachandra M.; Phillips, Bethan E.; Chakrabarty, Mallicka M; Lund, Jonathan N.

doi:10.1016/j.ejso.2013.11.009

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…This temporal factor may account for the absence of an observed reduction in tissue inflammation five weeks post-surgery. Indeed, within this time-frame muscle mass and physical performance were still diminished compared to pre-operative measures, suggesting that skeletal muscle function, structure and possibly metabolism [32][33] , were not normalised by this point.…”

Section: Discussionmentioning

confidence: 88%

A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection

et al. 2020

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Background: Resection of colorectal cancer (CRC) initiates inflammation, mediated at least partly by NFĸB (nuclear factor kappa-light-chain-enhancer of activated Bcells), leading to muscle catabolism and reduced physical performance.Eicosapentaenoic acid (EPA) has been shown to modulate NFĸB, but evidence for its benefit around the time of surgery is limited.Objective: To assess the effect of EPA supplementation on muscle inflammation and physical function around the time of major surgery. Design:In a double-blind randomized control trial, 61 patients (age: 68.3±0.95 y; 42 male) scheduled for CRC resection, received 3g per day of EPA (n=32) or placebo (n=29) for 5-days before and 21-days after operation. Lean muscle mass (LMM) (via dual energy X-ray absorptiometry (DXA)), anaerobic threshold (AT) (via cardiopulmonary exercise testing (CPET)) and hand-grip strength (HG) were assessed before and 4-weeks after surgery, with muscle biopsies (m. vastus lateralis) obtained for the assessment of NF-ĸB protein expression.Results: There were no differences in muscle NFĸB between EPA and placebo groups (mean difference (MD) -0.002; 95% confidence interval (CI) -0.19 to 0.19); p=0.98). There was no difference in LMM (MD 704.77g; 95% CI -1045.6g to 2455.13g; p=0.42) or AT (MD 1.11 mls/kg/min; 95% CI -0.52 mls/kg/min to 2.74 mls/kg/min; p=0.18) between the groups. Similarly, there was no difference between the groups in HG at follow up (MD 0.1; 95% CI -1.88 to 2.08; p=0.81). Results were similar when missing data was imputed. Conclusion:EPA supplementation confers no benefit in terms of inflammatory status, as judged by NFĸB, or preservation of LMM, aerobic capacity or physical function following major colorectal surgery.

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Section: Discussionmentioning

confidence: 88%

A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection

et al. 2020

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“…Although the underlying mechanisms affecting the magnitude of gains in CRF in these patients are not known, propositions based on previous findings can be made. Firstly, previous work in CRC patients has shown that AT significantly improves after resection of the cancer without a change in lean muscle mass or self‐reported physical activity . This suggests that physiological factors associated with the presence of a cancer (such as inflammation and impaired mitochondrial function) may lead to a blunting of the expected adaptive responses to exercise training while the cancer remains in situ.…”

Section: Discussionmentioning

confidence: 99%

Short‐term pre‐operative high‐intensity interval training does not improve fitness of colorectal cancer patients

Boereboom

Blackwell

Williams

et al. 2019

Scandinavian Med Sci Sports

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Background Pre‐operative cardiorespiratory fitness (CRF) in colorectal cancer (CRC) patients has been shown to affect post‐operative outcomes. The aim of this study was to test the feasibility of high‐intensity interval training (HIIT) for improving fitness in pre‐operative CRC patients within the 31‐day cancer waiting‐time targets imposed in the UK. Methods Eighteen CRC patients (13 males, mean age: 67 years (range: 52‐77 years) participated in supervised HIIT on cycle ergometers 3 or 4 times each week prior to surgery. Exercise intensity during 5 × 1‐minute HIIT intervals (interspersed with 90‐second recovery) was 100%‐120% maximum wattage achieved at a baseline cardiopulmonary exercise test (CPET). CPET before and after HIIT was used to assess CRF. Results Patients completed a mean of eight HIIT sessions (range 6‐14) over 19 days (SD 7). There was no significant increase in VO2 peak (23.9 ± 7.0 vs 24.2 ± 7.8 mL/kg/min (mean ± SD), P = 0.58) or anaerobic threshold (AT: 14.0 ± 3.4 vs 14.5 ± 4.5 mL/kg/min, P = 0.50) after HIIT. There was a significant reduction in resting systolic blood pressure (152 ± 19 vs 142 ± 19 mm Hg, P = 0.0005) and heart rate at submaximal exercise intensities after HIIT. Conclusions Our pragmatic HIIT exercise protocol did not improve the pre‐operative fitness of CRC patients within the 31‐day window available in the UK to meet cancer surgical waiting‐time targets.

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“…In addition, colorectal cancer patients presenting for resection have lower CRF than age-matched controls while the cancer is still in situ . However, removal the cancer facilitates a return toward normal CRF ( 73 ). Taken together, these studies may lead to a suggestion that tumour presence hinders adaptive capacity to exercise training, at least in this cancer type.…”

Section: Discussionmentioning

confidence: 99%

Short-Term (<8 wk) High-Intensity Interval Training in Diseased Cohorts

Blackwell

Doleman

Herrod

et al. 2018

Medicine &Amp; Science in Sports &Amp; Exercise

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Surgical resection of primary tumour improves aerobic performance in colorectal cancer

Cited by 8 publications

References 28 publications

A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection

A double-blind randomized controlled trial of the effects of eicosapentaenoic acid supplementation on muscle inflammation and physical function in patients undergoing colorectal cancer resection

Short‐term pre‐operative high‐intensity interval training does not improve fitness of colorectal cancer patients

Short-Term (<8 wk) High-Intensity Interval Training in Diseased Cohorts

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