Perioperative exercise training for patients with gastrointestinal cancer undergoing surgery: A systematic review and meta-analysis
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Authors
Thomsen, Simon N.Mørup, Stine Truel
Mau-Sørensen, Morten
Sillesen, Martin
Lahart, Ian
Christensen, Jesper F.
Issue Date
2021-07-13
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Exercise training is emerging as a supportive treatment strategy in surgical oncology, but its effects remain uncertain in patients with gastrointestinal cancer. The primary objective of this systematic review and meta-analysis was to evaluate the effects of perioperative exercise training on gastrointestinal cancer-specific mortality, recurrence, and surgical outcomes (postoperative complications, hospitalization, surgical stress) in patients with gastrointestinal cancer. Randomized or quasi-randomized controlled trials evaluating the effects of perioperative exercise training versus control in patients with GI cancer were eligible. MEDLINE, EMBASE, CENTRAL, CINAHL, PEDro, and SPORTDiscus were systematically searched on June 20, 2020. Data were synthesized using random-effects meta-analyses. Risk of bias was assessed using the Cochrane risk of bias tool 2, and the certainty of evidence was assessed using GRADE. Study selection, data extraction, risk of bias, and GRADE assessments were performed independently by two authors. Ten randomized controlled trials comprising 448 participants with gastrointestinal cancer were eligible. Meta-analyses indicated no statistical effects of exercise on postoperative complications (risk ratio: 1.11, 95% CI: 0.84; 1.47), readmissions (risk ratio: 2.76; 95% CI: 0.00, 9394.76), or postoperative length of stay (difference in means: −0.47, 95% CI: −17.2; 16.2 days). None of the eligible studies assessed gastrointestinal cancer-specific mortality or recurrence. Overall risk of bias was high or of some concerns in all studies, and the certainty of evidence was very low. The effects of perioperative exercise on cancer-specific and surgical outcomes are unknown in patients with gastrointestinal cancer due to lack of studies and very low certainty of evidence.Citation
Thomsen, S.N., Mørup, S.T., Mau-Sørensen, M., Sillesen, M., Lahart, I. and Christensen, J.F. (2021) Perioperative exercise training for patients with gastrointestinal cancer undergoing surgery: A systematic review and meta-analysis. European Journal of Surgical Oncology, 47(12), pp. 3028-3039.Publisher
ElsevierJournal
European Journal of Surgical OncologyPubMed ID
34294466 (pubmed)Additional Links
https://www.ejso.com/article/S0748-7983(21)00628-4/fulltext#%20Type
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enDescription
This is an accepted manuscript of an article published by Elsevier on 13/07/2021, available online: https://doi.org/10.1016/j.ejso.2021.07.007 The accepted version of the publication may differ from the final published version.ISSN
0748-7983EISSN
1532-2157ae974a485f413a2113503eed53cd6c53
10.1016/j.ejso.2021.07.007
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Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0/