Structured exercise program prior to major cancer surgery improves cardiopulmonary fitness: a retrospective cohort study

Purpose To determine if cardiopulmonary exercise testing (CPET) was useful in predicting response to exercise in cancer patients preoperatively. A secondary aim was to explore if exercise was associated with improved postoperative outcomes. Methods A retrospective cohort study was performed on consecutive cancer patients from 2012 to 2014, referred for exercise prehabilitation and had two CPET preoperatively. Results Twenty-six patients were analysed. There was a significant overall increase in oxygen uptake at anaerobic threshold (AT) from 10.4 to 11.6 ml kg −1 min −1 (ΔAT = 1.2 ± 3.0 ml kg −1 min −1 [9 %]; p = 0.046); peak oxygen uptake (pVO 2 ) from 16.0 to 17.7 ml kg −1 min −1 (ΔpVO 2 = 1.7 ± 2.4 ml kg −1 min −1 [9 %]; p = 0.002); and pVO 2 /BSA from 658 to 726 ml min −1 m −2 ; (ΔpVO 2 /BSA = 68 ± 112.3 mL min −1 m 2 [10 %]; p = 0.004). Fifty percent of patients were responders to exercise, defined as having >10 % increase in AT. Responders had a median increase in AT of 26 % [IQR 7 %, 45 %] with an absolute increase in AT of 2.5 ml kg −1 min −1 [IQR 1.1, 3.9] ( p = 0.002) and a median increase in pVO 2 of 22 % [IQR 11.5, 32.5 %] with an absolute increase in pVO 2 of 3.8 ml.kg −1 .min −1 [IQR 2.0, 5.7] ( p