What type of study is this?

This is a Meta-Analysis study (also classified as: Systematic Review).

September 17, 2025Open Access

Postoperative outcomes of preoperative exercise training in patients with operable non-small cell lung cancer: a systematic review and meta-analysis

Key Points

Preoperative exercise training significantly reduces postoperative complications in lung cancer patients.
Patients receiving exercise training had a notable decrease in hospital stay length by around 2 days, helping recovery.
The analysis included data from 16 randomized controlled trials with a combined total of 1,022 participants.
Improvements in pulmonary function were observed post-exercise training, supporting enhanced recovery outcomes.

Abstract

Introduction This meta-analysis was designed to compare the outcomes of preoperative exercise training versus no preoperative exercise for lung cancer patients scheduled for lung resection. Materials and methods Four databases (Medline, Embase, Web of Science, and CENTRAL) were searched for randomized controlled trials (RCTs) comparing preoperative exercise training versus no preoperative exercise for lung cancer patients scheduled for lung resection. The primary outcomes were postoperative complications and postoperative length of hospital stay. The secondary outcomes included post-intervention pulmonary function, severe postoperative complications, postoperative 30-day mortality, postoperative duration of chest tube drainage, post-intervention dyspnea, and post-intervention health-related quality of life (HRQoL). Results A total of 16 RCTs with 1,022 individuals were included in this meta-analysis. Compared with no preoperative exercise, preoperative exercise training significantly reduced the postoperative complications (OR = 0.33, 95%CI: 0.24 to 0.46, P 0.0001) and postoperative length of hospital stay (95%CI: −3.11 to −1.40, P 0.0001). In addition, preoperative exercise training significantly improved forced expiratory volume in 1 s (FEV 1 %) of predicted norm values (95%CI: 5.30 to 8.10, P 0.0001), forced vital capacity (FVC%) of predicted norm values (95%CI: 1.90 to 4.23, P 0.0001), peak expiratory flow (PEF) (95%CI: 12.44 to 60.93, P = 0.003), and peak oxygen uptake (VO 2peak ) (95%CI: 2.41 to 4.17, P 0.0001), while reducing severe postoperative complications (OR = 0.35, 95%CI: 0.21 to 0.56, P 0.0001) and post-intervention dyspnea (95%CI: −0.61 to 0.04, P = 0.02). There was no significant difference between the two groups regarding FEV 1 , FVC, carbon monoxide diffusing capacity (DLCO), six-minute walk distance (6MWD), postoperative 30-day mortality, postoperative chest tube drainage time, and post-intervention HRQoL. Conclusions This meta-analysis indicated that preoperative exercise training was effective for lung cancer patients scheduled for lung resection, potentially reducing postoperative complications and hospital stay duration, while improving post-intervention pulmonary function and exercise capacity. Systematic Review Registration https://www.crd.york.ac.uk/prospero/ , identifier CRD42024607156.

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