Decrease of physical fitness during neoadjuvant chemoradiotherapy predicts the risk of pneumonia after esophagectomy

Area of Science:

• Oncology
• Surgical Oncology
• Pulmonology

Background:

• Neoadjuvant chemoradiotherapy (nCRT) is a standard treatment for esophageal cancer.
• nCRT can lead to physical deconditioning, potentially indicating patient vulnerability.
• Postoperative pneumonia is a significant complication following esophagectomy.

Purpose of the Study:

• To assess if changes in physical fitness, weight, and fat-free mass index (FFMI) during nCRT predict postoperative pneumonia risk.
• To identify objective markers for predicting complications after esophageal cancer surgery.

Main Methods:

• Retrospective longitudinal observational cohort study of 91 esophageal cancer patients.
• Physical fitness (handgrip strength, leg extension strength, exercise capacity), weight, and FFMI measured pre- and post-nCRT.
• Logistic regression analysis to determine predictive value for postoperative pneumonia.

Main Results:

• Decreases in handgrip strength (OR 0.880) and exercise capacity (OR 0.939) during nCRT were significantly associated with postoperative pneumonia.
• All pneumonia cases occurred in patients experiencing declines in handgrip strength and exercise capacity.
• No significant association found for changes in weight or FFMI.

Conclusions:

• Reduced handgrip strength and exercise capacity during nCRT are predictive of pneumonia risk after esophagectomy.
• Pre- and post-nCRT physical fitness assessments can identify high-risk patients.
• This monitoring may aid in optimizing perioperative management for esophageal cancer patients.