Manuel Fernandez-Escabias, Javier Jurado, Sofia Carrilho-Candeias, Andrea Orellana-Jaen, Pablo Corres, Andres Marmol-Perez, Carl J Lavie, Almudena Carneiro-Barrera, Teresa Nestares, Francisco J Amaro-Gahete
{"title":"以运动为基础的康复对外科癌症患者心脏代谢健康的影响:系统回顾和荟萃分析","authors":"Manuel Fernandez-Escabias, Javier Jurado, Sofia Carrilho-Candeias, Andrea Orellana-Jaen, Pablo Corres, Andres Marmol-Perez, Carl J Lavie, Almudena Carneiro-Barrera, Teresa Nestares, Francisco J Amaro-Gahete","doi":"10.1007/s00520-025-09940-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to establish the effects of exercise-based prehabilitation programs on cardiometabolic health in patients with cancer undergoing surgery.</p><p><strong>Data source: </strong>A systematic search was conducted in MEDLINE (via PubMed) and Web of Science from inception to June 2023.</p><p><strong>Study selection: </strong>The original systematic search retrieved 16,752 studies. After removal of duplicates and screening by title and abstract, 200 articles were eligible for full-text revision. Finally, a total of nine randomized controlled trials (RCTs), four controlled studies, and six uncontrolled before-and-after studies were included.</p><p><strong>Outcome measures: </strong>Changes in blood pressure (systolic and diastolic), lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides levels), glycemic metabolism (fasting glucose, insulin, homeostatic model assessment for insulin resistance, and insulin-growth factor-1), and inflammatory biomarkers (i.e., interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and vascular endothelial growth factor) were assessed.</p><p><strong>Results: </strong>The total sample was composed of 651 participants (n = 311 intervention and n = 239 control from RCTs and controlled studies; n = 101 intervention from before-and-after studies), aged 64.90 ± 8.87 years (33.76% women). The meta-analyses of uncontrolled before-and-after studies revealed significant prehabilitation-induced reductions in systolic and diastolic blood pressure (d = - 0.47 and - 0.57, respectively). However, no changes were noted in lipid and glycemic metabolism or inflammatory biomarkers in either controlled or uncontrolled before-and-after studies.</p><p><strong>Limitations: </strong>These findings should be interpreted with caution. The small evidence base, inclusion of uncontrolled designs, substantial between-study heterogeneity, and the possibility of publication bias limit the robustness and generalizability of the conclusions.</p><p><strong>Conclusions: </strong>Exercise-based prehabilitation programs seems to be effective at reducing blood pressure in patients with cancer undergoing surgery. No effects were noted in other cardiometabolic health outcomes included.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 10","pages":"879"},"PeriodicalIF":3.0000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of exercise-based prehabilitation on cardiometabolic health in surgical patients with cancer: a systematic review and meta-analysis.\",\"authors\":\"Manuel Fernandez-Escabias, Javier Jurado, Sofia Carrilho-Candeias, Andrea Orellana-Jaen, Pablo Corres, Andres Marmol-Perez, Carl J Lavie, Almudena Carneiro-Barrera, Teresa Nestares, Francisco J Amaro-Gahete\",\"doi\":\"10.1007/s00520-025-09940-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to establish the effects of exercise-based prehabilitation programs on cardiometabolic health in patients with cancer undergoing surgery.</p><p><strong>Data source: </strong>A systematic search was conducted in MEDLINE (via PubMed) and Web of Science from inception to June 2023.</p><p><strong>Study selection: </strong>The original systematic search retrieved 16,752 studies. After removal of duplicates and screening by title and abstract, 200 articles were eligible for full-text revision. Finally, a total of nine randomized controlled trials (RCTs), four controlled studies, and six uncontrolled before-and-after studies were included.</p><p><strong>Outcome measures: </strong>Changes in blood pressure (systolic and diastolic), lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides levels), glycemic metabolism (fasting glucose, insulin, homeostatic model assessment for insulin resistance, and insulin-growth factor-1), and inflammatory biomarkers (i.e., interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and vascular endothelial growth factor) were assessed.</p><p><strong>Results: </strong>The total sample was composed of 651 participants (n = 311 intervention and n = 239 control from RCTs and controlled studies; n = 101 intervention from before-and-after studies), aged 64.90 ± 8.87 years (33.76% women). The meta-analyses of uncontrolled before-and-after studies revealed significant prehabilitation-induced reductions in systolic and diastolic blood pressure (d = - 0.47 and - 0.57, respectively). However, no changes were noted in lipid and glycemic metabolism or inflammatory biomarkers in either controlled or uncontrolled before-and-after studies.</p><p><strong>Limitations: </strong>These findings should be interpreted with caution. The small evidence base, inclusion of uncontrolled designs, substantial between-study heterogeneity, and the possibility of publication bias limit the robustness and generalizability of the conclusions.</p><p><strong>Conclusions: </strong>Exercise-based prehabilitation programs seems to be effective at reducing blood pressure in patients with cancer undergoing surgery. No effects were noted in other cardiometabolic health outcomes included.</p>\",\"PeriodicalId\":22046,\"journal\":{\"name\":\"Supportive Care in Cancer\",\"volume\":\"33 10\",\"pages\":\"879\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Supportive Care in Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00520-025-09940-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Supportive Care in Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00520-025-09940-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
目的:本系统综述和荟萃分析旨在建立基于运动的康复计划对癌症手术患者心脏代谢健康的影响。数据来源:系统检索MEDLINE(通过PubMed)和Web of Science,检索时间为建站至2023年6月。研究选择:原始系统检索检索到16,752项研究。在删除重复并按标题和摘要筛选后,有200篇文章符合全文修订的条件。最后,共纳入9项随机对照试验(rct)、4项对照研究和6项非对照前后研究。结果指标:评估血压(收缩压和舒张压)、脂质代谢(总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯水平)、血糖代谢(空腹血糖、胰岛素、胰岛素抵抗的稳态模型评估和胰岛素生长因子-1)和炎症生物标志物(即白细胞介素-6、肿瘤坏死因子- α、c反应蛋白和血管内皮生长因子)的变化。结果:共纳入651例受试者,其中干预组311例,对照组239例,干预前后对照组101例,年龄64.90±8.87岁,女性占33.76%。未控制的前后研究荟萃分析显示,预防诱导的收缩压和舒张压显著降低(d分别= - 0.47和- 0.57)。然而,在对照或非对照的前后研究中,脂质和血糖代谢或炎症生物标志物均未发生变化。局限性:这些发现应谨慎解释。证据基础小,纳入非受控设计,研究间存在大量异质性,以及发表偏倚的可能性限制了结论的稳健性和可推广性。结论:以运动为基础的康复计划似乎可以有效地降低接受手术的癌症患者的血压。在其他心脏代谢健康结果中没有发现影响。
Impact of exercise-based prehabilitation on cardiometabolic health in surgical patients with cancer: a systematic review and meta-analysis.
Objective: This systematic review and meta-analysis aimed to establish the effects of exercise-based prehabilitation programs on cardiometabolic health in patients with cancer undergoing surgery.
Data source: A systematic search was conducted in MEDLINE (via PubMed) and Web of Science from inception to June 2023.
Study selection: The original systematic search retrieved 16,752 studies. After removal of duplicates and screening by title and abstract, 200 articles were eligible for full-text revision. Finally, a total of nine randomized controlled trials (RCTs), four controlled studies, and six uncontrolled before-and-after studies were included.
Outcome measures: Changes in blood pressure (systolic and diastolic), lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides levels), glycemic metabolism (fasting glucose, insulin, homeostatic model assessment for insulin resistance, and insulin-growth factor-1), and inflammatory biomarkers (i.e., interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and vascular endothelial growth factor) were assessed.
Results: The total sample was composed of 651 participants (n = 311 intervention and n = 239 control from RCTs and controlled studies; n = 101 intervention from before-and-after studies), aged 64.90 ± 8.87 years (33.76% women). The meta-analyses of uncontrolled before-and-after studies revealed significant prehabilitation-induced reductions in systolic and diastolic blood pressure (d = - 0.47 and - 0.57, respectively). However, no changes were noted in lipid and glycemic metabolism or inflammatory biomarkers in either controlled or uncontrolled before-and-after studies.
Limitations: These findings should be interpreted with caution. The small evidence base, inclusion of uncontrolled designs, substantial between-study heterogeneity, and the possibility of publication bias limit the robustness and generalizability of the conclusions.
Conclusions: Exercise-based prehabilitation programs seems to be effective at reducing blood pressure in patients with cancer undergoing surgery. No effects were noted in other cardiometabolic health outcomes included.
期刊介绍:
Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease.
Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.