Key result
Pre-operative VO2peak correlates with post-surgery weight change but not with post-operative complications.
Why the study?
The prognostic value of VO2peak on post-operative outcomes after esophagectomy or gastrectomy remains uncertain and requires investigation.
Does pre-operative VO2peak predict post-operative outcomes in patients undergoing esophagectomy or gastrectomy?
Cross-Sectional (n=35)
Does pre-operative VO2peak predict post-operative outcomes in patients undergoing esophagectomy or gastrectomy?
Pre-operative VO2peak correlates with post-operative body weight changes but not significantly with major complications or length of stay in a small cohort of esophagectomy and gastrectomy patients.
Reduced pre-op VO2peak associates with post-op weight loss but not complications; leaves open its predictive role in esophagectomy/gastrectomy.
Background/Aim: Esophagectomy and gastrectomy are procedures with considerable physical burden and intense post-operative care of which the patient’s physical condition seems to be a relevant predictor. The gold standard of the cardiorespiratory fitness is the peak oxygen consumption (VO2peak). This pilot study examined the prognostic value of VO2peak on post-surgery outcomes in esophageal and gastric cancer patients. Patients and Methods: In this prospective cross-sectional study, patients scheduled for esophagectomy or gastrectomy were examined 24 h before the surgery regarding their VO2peak. The post-operative complications according to Clavien-Dindo grade IIIb/IV/V, Intensive-Care-Unit days, and overall hospital stay were documented following surgery. In a subset, body weight changes from surgery until hospital discharge and first aftercare visit were recorded. Results: The functional capacity was significantly reduced in 34/35 of the included patients compared to matched norm-values (p<0.01). The only significant correlation was found between VO2peak values and body weight change from surgery to the first aftercare visit. A subgroup comparison of patients with a VO2peak <17 ml/min/kg and ≥17 ml/min/kg suggested small, non-significant differences in post-surgery outcomes and significant differences in the body weight change from surgery to hospital discharge, favoring the higher-VO2peak subgroup. Conclusion: The impaired functional capacity following esophagectomy or gastrectomy may strengthen the rational for exercise programs during neoadjuvant and pre-surgery phases. The prognostic value of VO2peak on post-operative outcomes remains uncertain due to noticeable descriptive differences, but no significant correlations, potentially limited by the smallsized population. Nonetheless, a correlation between VO2peak and body weight change post-surgery was observed and indicates a potential prognostic value of VO2peak.
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Niels et al. (2022) conducted a cross-sectional in Esophageal and gastric cancer (n=35). VO2peak vs. Matched norm-values and lower VO2peak (<17 ml/min/kg) was evaluated on Post-operative complications (Clavien-Dindo grade IIIb/IV/V), ICU days, overall hospital stay, and body weight changes. Pre-operative VO2peak was significantly reduced in 34/35 patients compared to norm-values (p<0.01) and correlated with post-surgery body weight change, but not with post-operative complications.
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