Correlation between preoperative cardiopulmonary exercise testing and six-minute walk test, five-times sit to stand test and Short Form-36 physical component score in patients undergoing cytoreductive surgery

Introduction

Assessment of preoperative function is important for determining fitness for surgery, preoperative optimisation and predicting postoperative morbidity in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). This study explored correlations between preoperative cardiopulmonary exercise testing (CPET) variables, and six-minute walk test (6MWT), five-times sit to stand test (5STS) and Short Form-36 (SF-36) physical component score in patients scheduled for elective CRS-HIPEC.

Methods

This study included patients who underwent preoperative CPET, 6MWT, 5STS and responded to the SF-36 survey prior to elective CRS-HIPEC at Royal Prince Alfred Hospital in Sydney. CPET was performed using a cycle ergometer and measured peak oxygen uptake (VO2 peak) and anaerobic threshold (AT). The associations between preoperative CPET variables and preoperative 6MWT, 5STS and SF-36 were assessed using correlation test.

Results

A total of 133 patients scheduled for elective CRS-HIPEC were included in this study. The median VO₂, AT and VE/VCO₂ were 20.3 [6.5] ml/kg/min, 13.1 [4.9] ml/kg/min and 29 [4.5], respectively. The median 6MWT, 5STS and SF-36 physical component score were 525 m, 9.2 s and 50.2, respectively. CPET variables were significantly correlated with 6MWT (VO₂ r = 0.51; AT r = 0.35; VE/VCO₂ r = −0.25; p < 0.01), 5STS (VO₂ r = −0.32; AT r = −0.27; VE/VCO₂ r = 0.24; p < 0.01) and SF-36 (VO₂ r = 0.42; AT r = 0.38; VE/VCO₂ r = −0.23; p < 0.01).

Conclusions

6MWT, 5STS and SF-36 are at best moderately correlated with CPET variables, which suggests that these tests may serve as adjuncts rather than a replacement to CPET in the clinical setting.