Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial

Bott, R ORCID: 0000-0003-2030-2236, Zylstra, J, Knight, W, Whyte, GP, Lane, AM, Moss, C, Browning, M, Lagergren, J, Van Hemelrijck, M, Davies, AR, Gossage, J, Kelly, M, Baker, C, Taylor, J, Rusu, O, Evans, O, Tham, G, Dixon, T, Hallward, G, Taylor, C et al (2025) Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial. Journal of Surgical Oncology. ISSN 0022-4790

Preview

Text Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT) Outcomes From a Prospective Controlled Trial.pdf - Published Version Available under License Creative Commons Attribution. Download (836kB) | Preview

Abstract

Background: The Pre-EMPT study aimed to determine if structured exercise could reduce length of stay, post-operative complications and improve fitness and health-related quality of life (HQRL) in patients undergoing neoadjuvant chemotherapy (NAC) and oesophagectomy. Methods: A prospective non-randomised trial compared a standard care pathway (control) to a structured prehabilitation exercise programme (intervention) commenced before NAC and surgery for oesophageal adenocarcinoma. Length of hospital stay and post-operative complications were recorded. Cardiopulmonary exercise testing (CPEX), body composition analyses, lymphocyte levels and HRQL questionnaires were performed at multiple time points. Results: Median length of stay was similar in both groups. There were 6 versus 11 complications observed (intervention vs control p = 0.086). Cardio-pulmonary fitness (VO2peak) declined after NAC, but less in the intervention group (intervention −13.54% vs control −21.40%, p = 0.02). Body composition improved in the intervention group (FMi/FFMi −5.5% intervention, 10.7% control p = 0.043). Performance, cognitive, sleep and emotional function scores improved following NAC in the intervention group. Lymphocyte subsets increased in the intervention group compared to the control group after chemotherapy (p = 0.034). Chemotherapy response was improved in the intervention group (p = 0.022). Conclusion: A structured exercise programme may mitigate cardiopulmonary deconditioning, reduce sarcopenia and offset lymphopenia, during chemotherapy, in patients undergoing NAC and oesophagectomy.

Item Type:	Article
Uncontrolled Keywords:	Pre‐EMPT study group including the following co‐authors; cardiopulmonary exercise testing; health‐related quality of life; neoadjuvant chemotherapy; oesophageal adenocarcinoma; prehabilitation; 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Patient Safety; Prevention; Physical Activity; Behavioral and Social Science; Clinical Trials and Supportive Activities; Cancer; Clinical Research; 6.4 Surgery; 6.7 Physical; Cancer; 1112 Oncology and Carcinogenesis; Oncology & Carcinogenesis; 3211 Oncology and carcinogenesis
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Wiley
Date of acceptance:	18 December 2024
Date of first compliant Open Access:	12 March 2025
Date Deposited:	12 Mar 2025 10:04
Last Modified:	03 Jul 2025 15:00
DOI or ID number:	10.1002/jso.28079
URI:	https://researchonline.ljmu.ac.uk/id/eprint/25850

View Item