Decrease of physical fitness during neoadjuvant chemoradiotherapy predicts the risk of pneumonia after esophagectomy
| Autor: | A Kerst, Karin Valkenet, Petra Bor, B F Kingma, Elles Steenhagen, Cindy Veenhof, R. van Hillegersberg, Jelle P. Ruurda |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Esophageal Neoplasms medicine.medical_treatment Physical fitness 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Retrospective Studies Hand Strength business.industry Gastroenterology General Medicine Odds ratio Chemoradiotherapy Adjuvant Pneumonia Esophageal cancer medicine.disease Confidence interval Neoadjuvant Therapy Esophagectomy Treatment Outcome Physical Fitness 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business Chemoradiotherapy Cohort study |
| Zdroj: | Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 34(12) |
| ISSN: | 1442-2050 |
| Popis: | SUMMARY Although neoadjuvant chemoradiotherapy (nCRT) is frequently used in esophageal cancer patients undergoing treatment with curative intent, it can negatively impact patients’ physical fitness. A decline in physical fitness during chemoradiotherapy may be an indication of vulnerability. The aim of this study was to evaluate whether changes in physical fitness, weight, and fat-free mass index (FFMI) during nCRT can predict the risk of postoperative pneumonia. A retrospective longitudinal observational cohort study was performed in patients who received curative treatment for esophageal cancer between September 2016 and September 2018 in a high-volume center for esophageal cancer surgery. Physical fitness (handgrip strength, leg extension strength, and exercise capacity), weight, and FFMI were measured before and after chemoradiotherapy. To be included in the data analyses, pre- and post-nCRT data had to be available of at least one of the outcome measures. Logistic regression analyses were performed to evaluate the predictive value of changes in physical fitness, weight, and FFMI during nCRT on postoperative pneumonia, as defined by the Uniform Pneumonia Scale. In total, 91 patients were included in the data analyses. Significant associations were found between the changes in handgrip strength (odds ratio [OR] 0.880, 95% confidence interval [CI]: 0.813–0.952) and exercise capacity (OR 0.939, 95%CI: 0.887–0.993) and the occurrence of postoperative pneumonia. All pneumonias occurred in patients with declines in handgrip strength and exercise capacity after nCRT. A decrease of handgrip strength and exercise capacity during nCRT predicts the risk of pneumonia after esophagectomy for cancer. Measuring physical fitness before and after chemoradiotherapy seems an adequate method to identify patients at risk of postoperative pneumonia. |
| Databáze: | OpenAIRE |
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