Short-term preoperative exercise therapy does not improve long-term outcome after lung cancer surgery: a randomized controlled study

Karenovics W, Licker M, Ellenberger C, Christodoulou M, Diaper J,
Bhatia C, Robert J, Bridevaux PO, Triponez F

Eur J Cardiothorac Surg. 2017 Jul 1;52(1):47-54. doi: 10.1093/ejcts/ezx030

OBJECTIVES: Poor aerobic fitness is a potential modifiable risk factor for
long-term survival and quality of life in patients with lung cancer. This
randomized trial evaluates the impact of adding rehabilitation (Rehab) with
high-intensity interval training (HIIT) before lung cancer surgery to enhance
cardiorespiratory fitness and improve long-term postoperative outcome.
METHODS: Patients with operable lung cancer were randomly assigned to usual care
(UC, n  = 77) or to intervention group (Rehab, n  = 74) that entailed HIIT that
was implemented only preoperatively. Cardiopulmonary exercise testing (CPET) and
pulmonary functional tests (PFTs) including forced vital capacity (FVC), forced
expiratory volume (FEV 1 ) and carbon monoxide transfer factor (KCO) were
performed before and 1 year after surgery.
RESULTS: During the preoperative waiting time (median 25 days), Rehab patients
participated to a median of 8 HIIT sessions (interquartile [IQ] 25-75%, 7-10). At
1 year follow-up, 91% UC patients and 93% Rehab patients were still alive ( P
= 0.506). Pulmonary functional changes were non-significant and comparable in
both groups (FEV 1 mean -7.5%, 95% CI, -3.6 to -12.9 and in KCO mean 5.8% 95% CI
0.8-11.8) Compared with preoperative CPET results, both groups demonstrated
similar reduction in peak oxygen uptake (mean -12.2% 95% CI -4.8 to -18.2) and in
peak work rate (mean -11.1% 95% CI -4.2 to -17.4).
CONCLUSIONS: Short-term preoperative rehabilitation with HIIT does not improve
pulmonary function and aerobic capacity measured at 1 year after lung cancer