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Preoperative physical activity is associated with prognosis in patients with esophageal cancer undergoing thoracoscopic–laparoscopic esophagectomy after neoadjuvant chemotherapy

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Abstract

Objective

This study examined the association between a single preoperative physiotherapy session during neoadjuvant chemotherapy and physical function and that between preoperative physical activity and prognosis.

Methods

In this retrospective, single-center, observational study, we evaluated data from 234 patients scheduled for neoadjuvant chemotherapy and thoracoscopic–laparoscopic esophagectomy who underwent a single preoperative physiotherapy session. The five-repetition sit-to-stand test was performed before and after neoadjuvant chemotherapy. After neoadjuvant chemotherapy, patients were classified into high- and low-physical activity groups based on preoperative physical activity. To examine the association between preoperative physiotherapy and changes in physical function, a multivariate regression analysis was performed. The Cox proportional hazards model was used to investigate the association between preoperative physical activity and overall survival.

Results

The median percentage change in the five-repetition sit-to-stand test score was − 3.36%. In the multivariate regression analysis, the regression coefficient of the constant term was − 23.93 (95% confidence interval − 45.31 to − 2.56; P = 0.028). Low physical activity was significantly associated with overall survival after adjustment for confounding factors (P = 0.040).

Conclusions

This study demonstrated that a single preoperative physiotherapy session during neoadjuvant chemotherapy improves physical function, and preoperative physical activity is significantly associated with prognosis.

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Data Availability

Data supporting the findings of this study are available upon request from the corresponding authors. This study was not registered with an independent institutional registry.

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Acknowledgements

The authors thank the members of the Department of Musculoskeletal Oncology, Rehabilitation, and Esophageal Surgery at the National Cancer Center, Japan. This study would not have been possible without leadership and cooperation. 

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Authors and Affiliations

  1. Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan

    Takuya Fukushima, Noriko Watanabe, Yusuke Okita, Shota Yokota & Akira Kawai

  2. Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Daisuke Kurita, Koshiro Ishiyama, Junya Oguma & Hiroyuki Daiko

Authors
  1. Takuya Fukushima
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  2. Noriko Watanabe
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Contributions

All the authors contributed to the conception and design of this study. Material preparation, data collection, and analysis were performed by DK, TF, NW, YO, and SY. The first draft of the manuscript was written by TF and DH, and all the authors commented on previous versions of the manuscript. All the authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Hiroyuki Daiko.

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Conflict of interest

All the authors declare that they have no conflict of interest.

Ethics approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all the patients before their inclusion in the study.

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Fukushima, T., Watanabe, N., Okita, Y. et al. Preoperative physical activity is associated with prognosis in patients with esophageal cancer undergoing thoracoscopic–laparoscopic esophagectomy after neoadjuvant chemotherapy. Gen Thorac Cardiovasc Surg 72, 134–143 (2024). https://doi.org/10.1007/s11748-023-01977-w

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