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Postoperative outcomes of preoperative exercise training in patients with operable non-small cell lung cancer: a
Cuifang Li1, Haidan Meng1, Ye Wei1
1The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Introduction:
This meta-analysis was designed to compare the outcomes of preoperative exercise training versus no preoperative exercise for lung cancer patients scheduled for lung resection.
Materials And Methods:
Four databases (Medline, Embase, Web of Science, and CENTRAL) were searched for randomized controlled trials (RCTs) comparing preoperative exercise training versus no preoperative exercise for lung cancer patients scheduled for lung resection. The primary outcomes were postoperative complications and postoperative length of hospital stay. The secondary outcomes included post-intervention pulmonary function, severe postoperative complications, postoperative 30-day mortality, postoperative duration of chest tube drainage, post-intervention dyspnea, and post-intervention health-related quality of life (HRQoL).
Results:
A total of 16 RCTs with 1,022 individuals were included in this meta-analysis. Compared with no preoperative exercise, preoperative exercise training significantly reduced the postoperative complications (OR = 0.33, 95%CI: 0.24 to 0.46, P < 0.0001) and postoperative length of hospital stay (95%CI: -3.11 to -1.40, P < 0.0001). In addition, preoperative exercise training significantly improved forced expiratory volume in 1 s (FEV1%) of predicted norm values (95%CI: 5.30 to 8.10, P < 0.0001), forced vital capacity (FVC%) of predicted norm values (95%CI: 1.90 to 4.23, P < 0.0001), peak expiratory flow (PEF) (95%CI: 12.44 to 60.93, P = 0.003), and peak oxygen uptake (VO2peak) (95%CI: 2.41 to 4.17, P < 0.0001), while reducing severe postoperative complications (OR = 0.35, 95%CI: 0.21 to 0.56, P < 0.0001) and post-intervention dyspnea (95%CI: -0.61 to 0.04, P = 0.02). There was no significant difference between the two groups regarding FEV1, FVC, carbon monoxide diffusing capacity (DLCO), six-minute walk distance (6MWD), postoperative 30-day mortality, postoperative chest tube drainage time, and post-intervention HRQoL.
Conclusions:
This meta-analysis indicated that preoperative exercise training was effective for lung cancer patients scheduled for lung resection, potentially reducing postoperative complications and hospital stay duration, while improving post-intervention pulmonary function and exercise capacity.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/, identifier CRD42024607156.
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