Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial

the Pre-EMPT study group including the following co-authors

doi:10.1002/jso.28079

Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial

the Pre-EMPT study group including the following co-authors

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The Pre-EMPT study aimed to determine if structured exercise could reduce length of stay, post-operative complications and improve fitness and health-related quality of life (HQRL) in patients undergoing neoadjuvant chemotherapy (NAC) and oesophagectomy. Methods: A prospective non-randomised trial compared a standard care pathway (control) to a structured prehabilitation exercise programme (intervention) commenced before NAC and surgery for oesophageal adenocarcinoma. Length of hospital stay and post-operative complications were recorded. Cardiopulmonary exercise testing (CPEX), body composition analyses, lymphocyte levels and HRQL questionnaires were performed at multiple time points. Results: Median length of stay was similar in both groups. There were 6 versus 11 complications observed (intervention vs control p = 0.086). Cardio-pulmonary fitness (VO2peak) declined after NAC, but less in the intervention group (intervention −13.54% vs control −21.40%, p = 0.02). Body composition improved in the intervention group (FMi/FFMi −5.5% intervention, 10.7% control p = 0.043). Performance, cognitive, sleep and emotional function scores improved following NAC in the intervention group. Lymphocyte subsets increased in the intervention group compared to the control group after chemotherapy (p = 0.034). Chemotherapy response was improved in the intervention group (p = 0.022). Conclusion: A structured exercise programme may mitigate cardiopulmonary deconditioning, reduce sarcopenia and offset lymphopenia, during chemotherapy, in patients undergoing NAC and oesophagectomy.

Original language	English
Journal	Journal of surgical oncology
DOIs	https://doi.org/10.1002/jso.28079
Publication status	E-pub ahead of print - 29 Jan 2025

Keywords

cardiopulmonary exercise testing
health-related quality of life
neoadjuvant chemotherapy
oesophageal adenocarcinoma
prehabilitation

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10.1002/jso.28079

Cite this

@article{8279d470e8f84b9f9d176bdc96e4859e,

title = "Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial",

abstract = "Background: The Pre-EMPT study aimed to determine if structured exercise could reduce length of stay, post-operative complications and improve fitness and health-related quality of life (HQRL) in patients undergoing neoadjuvant chemotherapy (NAC) and oesophagectomy. Methods: A prospective non-randomised trial compared a standard care pathway (control) to a structured prehabilitation exercise programme (intervention) commenced before NAC and surgery for oesophageal adenocarcinoma. Length of hospital stay and post-operative complications were recorded. Cardiopulmonary exercise testing (CPEX), body composition analyses, lymphocyte levels and HRQL questionnaires were performed at multiple time points. Results: Median length of stay was similar in both groups. There were 6 versus 11 complications observed (intervention vs control p = 0.086). Cardio-pulmonary fitness (VO2peak) declined after NAC, but less in the intervention group (intervention −13.54% vs control −21.40%, p = 0.02). Body composition improved in the intervention group (FMi/FFMi −5.5% intervention, 10.7% control p = 0.043). Performance, cognitive, sleep and emotional function scores improved following NAC in the intervention group. Lymphocyte subsets increased in the intervention group compared to the control group after chemotherapy (p = 0.034). Chemotherapy response was improved in the intervention group (p = 0.022). Conclusion: A structured exercise programme may mitigate cardiopulmonary deconditioning, reduce sarcopenia and offset lymphopenia, during chemotherapy, in patients undergoing NAC and oesophagectomy.",

keywords = "cardiopulmonary exercise testing, health-related quality of life, neoadjuvant chemotherapy, oesophageal adenocarcinoma, prehabilitation",

author = "{the Pre-EMPT study group including the following co-authors} and R. Bott and J. Zylstra and W. Knight and Whyte, {G. P.} and Lane, {A. M.} and C. Moss and M. Browning and J. Lagergren and {Van Hemelrijck}, M. and Davies, {A. R.} and J. Gossage and M. Kelly and C. Baker and J. Taylor and O. Rusu and O. Evans and G. Tham and T. Dixon and G. Hallward and C. Taylor and N. Maisey and S. Ngan and A. Lumsden and K. Owczarczyk and A. Qureshi and N. Griffin and A. Jacques and V. Goh and M. Green and H. Deere and F. Chang and U. Mahadeva and B. Gill-Barman and M. Ong and S. George and J. Dunn and S. Zeki and J. Waters and M. Cominos and T. Sevitt and M. Hill and Ollala, {A. Santa} and K. Beckmann and L. Gervais-Andre and J. Pate",

note = "Publisher Copyright: {\textcopyright} 2025 Wiley Periodicals LLC.",

year = "2025",

month = jan,

day = "29",

doi = "10.1002/jso.28079",

language = "English",

journal = "Journal of surgical oncology",

issn = "0022-4790",

publisher = "Wiley",

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TY - JOUR

T1 - Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT)

T2 - Outcomes From a Prospective Controlled Trial

AU - the Pre-EMPT study group including the following co-authors

AU - Bott, R.

AU - Zylstra, J.

AU - Knight, W.

AU - Whyte, G. P.

AU - Lane, A. M.

AU - Moss, C.

AU - Browning, M.

AU - Lagergren, J.

AU - Van Hemelrijck, M.

AU - Davies, A. R.

AU - Gossage, J.

AU - Kelly, M.

AU - Baker, C.

AU - Taylor, J.

AU - Rusu, O.

AU - Evans, O.

AU - Tham, G.

AU - Dixon, T.

AU - Hallward, G.

AU - Taylor, C.

AU - Maisey, N.

AU - Ngan, S.

AU - Lumsden, A.

AU - Owczarczyk, K.

AU - Qureshi, A.

AU - Griffin, N.

AU - Jacques, A.

AU - Goh, V.

AU - Green, M.

AU - Deere, H.

AU - Chang, F.

AU - Mahadeva, U.

AU - Gill-Barman, B.

AU - Ong, M.

AU - George, S.

AU - Dunn, J.

AU - Zeki, S.

AU - Waters, J.

AU - Cominos, M.

AU - Sevitt, T.

AU - Hill, M.

AU - Ollala, A. Santa

AU - Beckmann, K.

AU - Gervais-Andre, L.

AU - Pate, J.

PY - 2025/1/29

Y1 - 2025/1/29

N2 - Background: The Pre-EMPT study aimed to determine if structured exercise could reduce length of stay, post-operative complications and improve fitness and health-related quality of life (HQRL) in patients undergoing neoadjuvant chemotherapy (NAC) and oesophagectomy. Methods: A prospective non-randomised trial compared a standard care pathway (control) to a structured prehabilitation exercise programme (intervention) commenced before NAC and surgery for oesophageal adenocarcinoma. Length of hospital stay and post-operative complications were recorded. Cardiopulmonary exercise testing (CPEX), body composition analyses, lymphocyte levels and HRQL questionnaires were performed at multiple time points. Results: Median length of stay was similar in both groups. There were 6 versus 11 complications observed (intervention vs control p = 0.086). Cardio-pulmonary fitness (VO2peak) declined after NAC, but less in the intervention group (intervention −13.54% vs control −21.40%, p = 0.02). Body composition improved in the intervention group (FMi/FFMi −5.5% intervention, 10.7% control p = 0.043). Performance, cognitive, sleep and emotional function scores improved following NAC in the intervention group. Lymphocyte subsets increased in the intervention group compared to the control group after chemotherapy (p = 0.034). Chemotherapy response was improved in the intervention group (p = 0.022). Conclusion: A structured exercise programme may mitigate cardiopulmonary deconditioning, reduce sarcopenia and offset lymphopenia, during chemotherapy, in patients undergoing NAC and oesophagectomy.

AB - Background: The Pre-EMPT study aimed to determine if structured exercise could reduce length of stay, post-operative complications and improve fitness and health-related quality of life (HQRL) in patients undergoing neoadjuvant chemotherapy (NAC) and oesophagectomy. Methods: A prospective non-randomised trial compared a standard care pathway (control) to a structured prehabilitation exercise programme (intervention) commenced before NAC and surgery for oesophageal adenocarcinoma. Length of hospital stay and post-operative complications were recorded. Cardiopulmonary exercise testing (CPEX), body composition analyses, lymphocyte levels and HRQL questionnaires were performed at multiple time points. Results: Median length of stay was similar in both groups. There were 6 versus 11 complications observed (intervention vs control p = 0.086). Cardio-pulmonary fitness (VO2peak) declined after NAC, but less in the intervention group (intervention −13.54% vs control −21.40%, p = 0.02). Body composition improved in the intervention group (FMi/FFMi −5.5% intervention, 10.7% control p = 0.043). Performance, cognitive, sleep and emotional function scores improved following NAC in the intervention group. Lymphocyte subsets increased in the intervention group compared to the control group after chemotherapy (p = 0.034). Chemotherapy response was improved in the intervention group (p = 0.022). Conclusion: A structured exercise programme may mitigate cardiopulmonary deconditioning, reduce sarcopenia and offset lymphopenia, during chemotherapy, in patients undergoing NAC and oesophagectomy.

KW - cardiopulmonary exercise testing

KW - health-related quality of life

KW - neoadjuvant chemotherapy

KW - oesophageal adenocarcinoma

KW - prehabilitation

UR - http://www.scopus.com/inward/record.url?scp=85216858098&partnerID=8YFLogxK

U2 - 10.1002/jso.28079

DO - 10.1002/jso.28079

M3 - Article

AN - SCOPUS:85216858098

SN - 0022-4790

JO - Journal of surgical oncology

JF - Journal of surgical oncology

ER -

Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial

Abstract

Keywords

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