Effectiveness of early exercise on reducing skeletal muscle loss during preoperative neoadjuvant chemotherapy for esophageal cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 52; no. 8; pp. 1143 - 1152
• Main Authors: Ikeda, Tomohiro, Noma, Kazuhiro, Maeda, Naoaki, Tanabe, Shunsuke, Sakamoto, Yoko, Katayama, Yoshimi, Shirakawa, Yasuhiro, Fujiwara, Toshiyoshi, Senda, Masuo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.08.2022
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical Oncology; Neoadjuvant therapy; Exercise; Skeletal muscle; Esophagus
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-021-02449-5

Purpose To investigate if early exercise can help prevent skeletal muscle loss and improve the clinical outcomes of esophageal cancer patients receiving preoperative neoadjuvant chemotherapy (NAC). Methods This was a single-center, retrospective observational cohort study of 110 patients with advanced esophageal cancer. We analyzed the effect of early exercise on the risk of skeletal muscle loss (defined as > 2.98%) during NAC and the subsequent clinical outcomes. Patients in the early exercise group ( n  = 71) started exercise therapy 8 days earlier than those the late exercise group ( n  = 39). Results The median age of the patients was 65.4 years, the mean BMI was 21.1 kg/m 2 , and 92 (84%) of the 110 patients were men. Skeletal muscle loss occurred in 34% and 67% of the early and late exercise groups, respectively ( p  < 0.001). There was a lower risk of surgical site infection in the early exercise group (1% vs 16%, p  = 0.021). Multivariate analysis revealed that early exercise reduced the risk of skeletal muscle loss (OR = 0.25, 95% CI 0.09–0.65, p  = 0.006). Conclusions Our results suggest that early exercise reduces the risk of both skeletal muscle loss during NAC and subsequent surgical site infection in patients with esophageal cancer.