Preoperative physical activity predicts postoperative functional recovery in gastrointestinal cancer patients

Abstract

Purpose

The present study aimed to investigate the association between preoperative physical activity (PA) and postoperative functional recovery in gastrointestinal cancer patients.

Materials and methods

In this prospective study, we included 101 patients who underwent colorectal or gastric cancer surgery. Primary outcome was 6-minute walk distance (6MWD) decline ratio ((postoperative 6MWD value – preoperative 6MWD value)/preoperative 6MWD value × 100 (%)), which was determined as postoperative functional recovery. Patients were divided into two groups according to the median of 6MWD decline ratio: above the median (non-decline group) and below the median (decline group). The International Physical Activity Questionnaire (IPAQ-SV) (the usual seven-day short version) was used to assess preoperative PA and sedentary time. Multivariate logistic regression analysis was performed to identify predictive factors of postoperative functional recovery.

Results

Preoperative PA (odds ratio (OR): 3.812; 95% confidence interval (CI): 1.326–10.956; p = 0.01), 6MWD (OR: 1.006; 95% CI: 1.002–1.011; p < 0.01), C-reactive protein (OR: 4.138; 95% CI: 1.383–12.377; p = 0.01), and combined resection (OR: 3.425; 95% CI: 1.101–10.649; p = 0.03) were associated with postoperative functional recovery.

Conclusions

Preoperative PA is a predictor of postoperative functional recovery in patients who undergoing gastrointestinal cancer surgery.

Implications for rehabilitation

• The association between preoperative physical activity (PA) and postoperative functional recovery has been unclear in gastrointestinal cancer patients.

• We indicated that preoperative PA predicts postoperative functional recovery.

• Patients who low preoperative PA need to be monitored carefully in the postoperative course.

• Patients with low preoperative PA may need enhanced postoperative rehabilitation to reduce postoperative functional decline.

Keywords:

• Physical activity
• postoperative functional recovery
• older patient
• colorectal cancer
• gastric cancer

Acknowledgements

We thank all patients who participated in the present study. We also thank collaborating surgeons and other medical staff for their important contributions to our study. We would like to thank Editage (www.editage.com) for English language editing.

Disclosure statement

The authors report no conflicts of interest associated with this manuscript.

Additional information

Funding

This work was supported in part by JSPS KAKENHI (Grant Number 18H03127 to H. Sugiura) from the Japan Society for the Promotion Science.