Physical decline and its implications in the management of oesophageal and gastric cancer: a systematic review
Purpose The management of oesophageal and gastric cancer can cause significant physical decline, impacting on completion rates and outcomes. This systematic review aimed to (i) determine the impact of chemotherapy, chemoradiotherapy and surgery on physical function; (ii) identify associations betwee...
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| Veröffentlicht in: | Journal of cancer survivorship 2018-08, Vol.12 (4), p.601-618 |
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| container_title | Journal of cancer survivorship |
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| creator | O’Neill, Linda Moran, Jonathan Guinan, Emer M. Reynolds, John V. Hussey, Juliette |
| description | Purpose
The management of oesophageal and gastric cancer can cause significant physical decline, impacting on completion rates and outcomes. This systematic review aimed to (i) determine the impact of chemotherapy, chemoradiotherapy and surgery on physical function; (ii) identify associations between physical function and post-operative outcomes; and (iii) examine the effects of rehabilitation on physical function.
Methods
We included randomised controlled trials (RCT), non-RCTs of interventions and cohort studies that measured physical function by objective means in patients with oesophageal or gastric cancer. EMBASE, PubMed, CINAHL, Cochrane Library, SCOPUS, PEDro and the WHO Trial Registry were searched up to June 2016. Risk of bias assessment was performed using a suite of validated tools.
Results
Twenty-five studies involving 1897 participants were included. A meta-analysis was not indicated due to the heterogeneity of the literature. Significant reductions in physical function occur in patients undergoing neoadjuvant treatment and in the first 3 months post-resection. Lower pre-operative exercise capacity is associated with an increased risk of post-operative pulmonary complications (PPCs). Evidence to support exercise prehabilitation and rehabilitation in these treatment pathways is currently lacking.
Conclusions
Chemotherapy, chemoradiation and surgery lead to reduced physical function in patients with oesophageal and gastric cancer. High quality evidence is lacking to prove the benefit of interventions that improve physical function through the treatment pathway and in recovery, and well-designed studies are required. This review was limited due to the heterogeneity of the literature, high risk of bias in some articles and the lack of high quality research encompassing sufficient time points in the patient journey.
Implications for Cancer Survivors
Curative treatment for oesophago-gastric cancer can negatively impact on physical function. Rehabilitation programmes have considerable potential to enhance physical function across the oesophago-gastric cancer journey. |
| doi_str_mv | 10.1007/s11764-018-0696-6 |
| format | Article |
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The management of oesophageal and gastric cancer can cause significant physical decline, impacting on completion rates and outcomes. This systematic review aimed to (i) determine the impact of chemotherapy, chemoradiotherapy and surgery on physical function; (ii) identify associations between physical function and post-operative outcomes; and (iii) examine the effects of rehabilitation on physical function.
Methods
We included randomised controlled trials (RCT), non-RCTs of interventions and cohort studies that measured physical function by objective means in patients with oesophageal or gastric cancer. EMBASE, PubMed, CINAHL, Cochrane Library, SCOPUS, PEDro and the WHO Trial Registry were searched up to June 2016. Risk of bias assessment was performed using a suite of validated tools.
Results
Twenty-five studies involving 1897 participants were included. A meta-analysis was not indicated due to the heterogeneity of the literature. Significant reductions in physical function occur in patients undergoing neoadjuvant treatment and in the first 3 months post-resection. Lower pre-operative exercise capacity is associated with an increased risk of post-operative pulmonary complications (PPCs). Evidence to support exercise prehabilitation and rehabilitation in these treatment pathways is currently lacking.
Conclusions
Chemotherapy, chemoradiation and surgery lead to reduced physical function in patients with oesophageal and gastric cancer. High quality evidence is lacking to prove the benefit of interventions that improve physical function through the treatment pathway and in recovery, and well-designed studies are required. This review was limited due to the heterogeneity of the literature, high risk of bias in some articles and the lack of high quality research encompassing sufficient time points in the patient journey.
Implications for Cancer Survivors
Curative treatment for oesophago-gastric cancer can negatively impact on physical function. Rehabilitation programmes have considerable potential to enhance physical function across the oesophago-gastric cancer journey.</description><identifier>ISSN: 1932-2259</identifier><identifier>EISSN: 1932-2267</identifier><identifier>DOI: 10.1007/s11764-018-0696-6</identifier><identifier>PMID: 29796931</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bias ; Cancer ; Chemoradiotherapy ; Chemotherapy ; Clinical trials ; Complications ; Control methods ; Esophageal cancer ; Esophagus ; Gastric cancer ; Health Informatics ; Health Promotion and Disease Prevention ; Heterogeneity ; Medicine ; Medicine & Public Health ; Oncology ; Patients ; Primary Care Medicine ; Public Health ; Quality of Life Research ; Rehabilitation ; Review ; Surgery ; Systematic review</subject><ispartof>Journal of cancer survivorship, 2018-08, Vol.12 (4), p.601-618</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Journal of Cancer Survivorship is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-8aaa22e08e858ea7b376fd91e63e268575c4a20c369f308dfd664c31690e8e153</citedby><cites>FETCH-LOGICAL-c438t-8aaa22e08e858ea7b376fd91e63e268575c4a20c369f308dfd664c31690e8e153</cites><orcidid>0000-0002-0109-9650</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11764-018-0696-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11764-018-0696-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29796931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O’Neill, Linda</creatorcontrib><creatorcontrib>Moran, Jonathan</creatorcontrib><creatorcontrib>Guinan, Emer M.</creatorcontrib><creatorcontrib>Reynolds, John V.</creatorcontrib><creatorcontrib>Hussey, Juliette</creatorcontrib><title>Physical decline and its implications in the management of oesophageal and gastric cancer: a systematic review</title><title>Journal of cancer survivorship</title><addtitle>J Cancer Surviv</addtitle><addtitle>J Cancer Surviv</addtitle><description>Purpose
The management of oesophageal and gastric cancer can cause significant physical decline, impacting on completion rates and outcomes. This systematic review aimed to (i) determine the impact of chemotherapy, chemoradiotherapy and surgery on physical function; (ii) identify associations between physical function and post-operative outcomes; and (iii) examine the effects of rehabilitation on physical function.
Methods
We included randomised controlled trials (RCT), non-RCTs of interventions and cohort studies that measured physical function by objective means in patients with oesophageal or gastric cancer. EMBASE, PubMed, CINAHL, Cochrane Library, SCOPUS, PEDro and the WHO Trial Registry were searched up to June 2016. Risk of bias assessment was performed using a suite of validated tools.
Results
Twenty-five studies involving 1897 participants were included. A meta-analysis was not indicated due to the heterogeneity of the literature. Significant reductions in physical function occur in patients undergoing neoadjuvant treatment and in the first 3 months post-resection. Lower pre-operative exercise capacity is associated with an increased risk of post-operative pulmonary complications (PPCs). Evidence to support exercise prehabilitation and rehabilitation in these treatment pathways is currently lacking.
Conclusions
Chemotherapy, chemoradiation and surgery lead to reduced physical function in patients with oesophageal and gastric cancer. High quality evidence is lacking to prove the benefit of interventions that improve physical function through the treatment pathway and in recovery, and well-designed studies are required. This review was limited due to the heterogeneity of the literature, high risk of bias in some articles and the lack of high quality research encompassing sufficient time points in the patient journey.
Implications for Cancer Survivors
Curative treatment for oesophago-gastric cancer can negatively impact on physical function. Rehabilitation programmes have considerable potential to enhance physical function across the oesophago-gastric cancer journey.</description><subject>Bias</subject><subject>Cancer</subject><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Control methods</subject><subject>Esophageal cancer</subject><subject>Esophagus</subject><subject>Gastric cancer</subject><subject>Health Informatics</subject><subject>Health Promotion and Disease Prevention</subject><subject>Heterogeneity</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Patients</subject><subject>Primary Care Medicine</subject><subject>Public Health</subject><subject>Quality of Life Research</subject><subject>Rehabilitation</subject><subject>Review</subject><subject>Surgery</subject><subject>Systematic review</subject><issn>1932-2259</issn><issn>1932-2267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kUlLBDEQhYMo7j_AiwS8eGnN0p3FmwxuIOhBzyGTrp7J0J0ekx5l_r1pxgUET5VKfe9VyEPohJILSoi8TJRKURaEqoIILQqxhfap5qxgTMjtn3Ol99BBSgtCKqYp20V7TEstNKf7KDzP18k72-IaXOsDYBtq7IeEfbds82DwfchNwMMccGeDnUEHYcB9g3tI_XKeL7J6VM1sGqJ32NngIF5hi9M6DdBlD4cjvHv4OEI7jW0THH_VQ_R6e_MyuS8en-4eJtePhSu5GgplrWUMiAJVKbByyqVoak1BcGBCVbJypWXEcaEbTlTd1EKUjlOhCSigFT9E5xvfZezfVpAG0_nkoG1tgH6VDCNlxaQQXGb07A-66Fcx5NeNFNMVY3I0pBvKxT6lCI1ZRt_ZuDaUmDEMswnD5DDMGIYRWXP65byadlD_KL5_PwNsA6Q8CjOIv6v_d_0Ef2eUtg</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>O’Neill, Linda</creator><creator>Moran, Jonathan</creator><creator>Guinan, Emer M.</creator><creator>Reynolds, John V.</creator><creator>Hussey, Juliette</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0109-9650</orcidid></search><sort><creationdate>20180801</creationdate><title>Physical decline and its implications in the management of oesophageal and gastric cancer: a systematic review</title><author>O’Neill, Linda ; Moran, Jonathan ; Guinan, Emer M. ; Reynolds, John V. ; Hussey, Juliette</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-8aaa22e08e858ea7b376fd91e63e268575c4a20c369f308dfd664c31690e8e153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Bias</topic><topic>Cancer</topic><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Control methods</topic><topic>Esophageal cancer</topic><topic>Esophagus</topic><topic>Gastric cancer</topic><topic>Health Informatics</topic><topic>Health Promotion and Disease Prevention</topic><topic>Heterogeneity</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Patients</topic><topic>Primary Care Medicine</topic><topic>Public Health</topic><topic>Quality of Life Research</topic><topic>Rehabilitation</topic><topic>Review</topic><topic>Surgery</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O’Neill, Linda</creatorcontrib><creatorcontrib>Moran, Jonathan</creatorcontrib><creatorcontrib>Guinan, Emer M.</creatorcontrib><creatorcontrib>Reynolds, John V.</creatorcontrib><creatorcontrib>Hussey, Juliette</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cancer survivorship</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O’Neill, Linda</au><au>Moran, Jonathan</au><au>Guinan, Emer M.</au><au>Reynolds, John V.</au><au>Hussey, Juliette</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Physical decline and its implications in the management of oesophageal and gastric cancer: a systematic review</atitle><jtitle>Journal of cancer survivorship</jtitle><stitle>J Cancer Surviv</stitle><addtitle>J Cancer Surviv</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>12</volume><issue>4</issue><spage>601</spage><epage>618</epage><pages>601-618</pages><issn>1932-2259</issn><eissn>1932-2267</eissn><abstract>Purpose
The management of oesophageal and gastric cancer can cause significant physical decline, impacting on completion rates and outcomes. This systematic review aimed to (i) determine the impact of chemotherapy, chemoradiotherapy and surgery on physical function; (ii) identify associations between physical function and post-operative outcomes; and (iii) examine the effects of rehabilitation on physical function.
Methods
We included randomised controlled trials (RCT), non-RCTs of interventions and cohort studies that measured physical function by objective means in patients with oesophageal or gastric cancer. EMBASE, PubMed, CINAHL, Cochrane Library, SCOPUS, PEDro and the WHO Trial Registry were searched up to June 2016. Risk of bias assessment was performed using a suite of validated tools.
Results
Twenty-five studies involving 1897 participants were included. A meta-analysis was not indicated due to the heterogeneity of the literature. Significant reductions in physical function occur in patients undergoing neoadjuvant treatment and in the first 3 months post-resection. Lower pre-operative exercise capacity is associated with an increased risk of post-operative pulmonary complications (PPCs). Evidence to support exercise prehabilitation and rehabilitation in these treatment pathways is currently lacking.
Conclusions
Chemotherapy, chemoradiation and surgery lead to reduced physical function in patients with oesophageal and gastric cancer. High quality evidence is lacking to prove the benefit of interventions that improve physical function through the treatment pathway and in recovery, and well-designed studies are required. This review was limited due to the heterogeneity of the literature, high risk of bias in some articles and the lack of high quality research encompassing sufficient time points in the patient journey.
Implications for Cancer Survivors
Curative treatment for oesophago-gastric cancer can negatively impact on physical function. Rehabilitation programmes have considerable potential to enhance physical function across the oesophago-gastric cancer journey.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29796931</pmid><doi>10.1007/s11764-018-0696-6</doi><tpages>18</tpages><orcidid>https://orcid.org/0000-0002-0109-9650</orcidid></addata></record> |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Bias Cancer Chemoradiotherapy Chemotherapy Clinical trials Complications Control methods Esophageal cancer Esophagus Gastric cancer Health Informatics Health Promotion and Disease Prevention Heterogeneity Medicine Medicine & Public Health Oncology Patients Primary Care Medicine Public Health Quality of Life Research Rehabilitation Review Surgery Systematic review |
| title | Physical decline and its implications in the management of oesophageal and gastric cancer: a systematic review |
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