Preoperative cardiopulmonary exercise testing, specifically oxygen uptake at lactate threshold, predicted postoperative morbidity after rectal cancer surgery (AUC 0.87; 95% CI 0.78-0.95; P<0.001).
Observational (n=95)
Double-blind assessment
Does preoperative cardiopulmonary exercise testing predict in-hospital morbidity in patients undergoing rectal cancer surgery?
Preoperative cardiopulmonary exercise testing can help predict in-hospital morbidity after rectal cancer surgery.
Effect estimate: AUC 0.87 (95% CI 0.78 to 0.95)
p-value: p=<0.001
BACKGROUND: This study investigated the relationship between objectively measured physical fitness variables derived by cardiopulmonary exercise testing (CPET) and in-hospital morbidity after rectal cancer surgery. METHODS: Patients scheduled for rectal cancer surgery underwent preoperative CPET (reported blind to patient characteristics) with recording of morbidity (recorded blind to CPET variables). Non-parametric receiver operating characteristic (ROC) curves and logistic regression were used to assess the relationship between CPET variables and postoperative morbidity. RESULTS: Of 105 patients assessed, 95 (72 men) were included; ten patients had no surgery and were excluded (3 by choice, 7 owing to unresectable metastasis). Sixty-eight patients had received neoadjuvant treatment. ROC curve analysis of oxygen uptake (V˙o2) at estimated lactate threshold (θL) and peak V˙o2 gave an area under the ROC curve of 0·87 (95 per cent confidence interval 0·78 to 0·95; P < 0·001) and 0·85 (0·77 to 0·93; P < 0·001) respectively, indicating that they can help discriminate patients at risk of postoperative morbidity. The optimal cut-off points identified were 10·6 and 18·6 ml per kg per min for V˙o2 at θL and peak respectively. CONCLUSION: CPET can help predict morbidity after rectal cancer surgery.
West et al. (Wed,) conducted a observational in Rectal cancer (n=95). Cardiopulmonary exercise testing (CPET) was evaluated on In-hospital morbidity (AUC 0.87, 95% CI 0.78 to 0.95, p=<0.001). Preoperative cardiopulmonary exercise testing, specifically oxygen uptake at lactate threshold, predicted postoperative morbidity after rectal cancer surgery (AUC 0.87; 95% CI 0.78-0.95; P<0.001).