Postoperative outcomes of preoperative exercise training in patients with operable non-small cell lung cancer: a systematic review and meta-analysis.

IF 3.5 3区医学 Q2 ONCOLOGY

Frontiers in Oncology Pub Date : 2025-09-12 eCollection Date: 2025-01-01 DOI:10.3389/fonc.2025.1563478

Cuifang Li, Haidan Meng, Ye Wei, Yugan Liang, Yangqian Xu, Xiaomeng Huang, Weiming Liang, Jieru Quan, Shanguang Wu, Xueyan Wei

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Abstract

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 (VO_2peak) (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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可手术非小细胞肺癌患者术前运动训练的术后效果：系统回顾和荟萃分析

本荟萃分析旨在比较计划肺切除术的肺癌患者术前运动训练与术前不运动的结果。材料和方法：四个数据库（Medline, Embase， Web of Science和CENTRAL）检索了随机对照试验（rct），比较术前运动训练与术前不运动对肺癌患者肺切除术的影响。主要结局为术后并发症和术后住院时间。次要结局包括干预后肺功能、术后严重并发症、术后30天死亡率、术后胸管引流时间、干预后呼吸困难和干预后健康相关生活质量（HRQoL）。结果：本荟萃分析共纳入16项随机对照试验，共1,022名受试者。与术前无运动相比，术前运动训练显著减少了术后并发症（OR = 0.33, 95%CI: 0.24 ~ 0.46, P < 0.0001）和术后住院时间（95%CI: -3.11 ~ -1.40, P < 0.0001）。此外，术前运动训练显著改善了预测正常值的1 s用力呼气量（FEV1%）（95%CI: 5.30 ~ 8.10, P < 0.0001）、预测正常值的用力肺活量（FVC%）（95%CI: 1.90 ~ 4.23, P < 0.0001）、呼气峰流量（PEF）（95%CI: 12.44 ~ 60.93, P = 0.003）、峰值吸氧（VO2peak）（95%CI: 2.41 ~ 4.17, P < 0.0001），同时减少了严重的术后并发症（OR = 0.35, 95%CI: 0.0001）。0.21 ~ 0.56, P < 0.0001)和干预后呼吸困难（95%CI: -0.61 ~ 0.04, P = 0.02）。两组患者FEV1、FVC、一氧化碳弥散量（DLCO）、6分钟步行距离（6MWD）、术后30天死亡率、术后胸管引流时间、干预后HRQoL差异无统计学意义。结论：本荟萃分析表明，术前运动训练对计划肺切除术的肺癌患者有效，可能减少术后并发症和住院时间，同时改善干预后肺功能和运动能力。系统综述注册：https://www.crd.york.ac.uk/prospero/，标识符CRD42024607156。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Oncology Biochemistry, Genetics and Molecular Biology-Cancer Research

CiteScore

6.20

自引率

10.60%

发文量

6641

审稿时长

14 weeks

期刊介绍： Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.