Surgical resection of primary tumour improves aerobic performance in colorectal cancer

Williams, John P. and Nyasavajjala, Sitaramachandra M. and Phillips, Beth E. and Chakrabarty, M. and Lund, Jonathan N. (2014) Surgical resection of primary tumour improves aerobic performance in colorectal cancer. European Journal of Surgical Oncology (EJSO), 40 (2). pp. 220-226. ISSN 0748-7983

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Abstract

Background

Colorectal cancer is the third most common cancer in the UK, with patients suffering declines in muscle mass and aerobic function. We hypothesised that tumour removal in non-metastatic colorectal cancer would lead to a restoration of lean muscle mass and increases in objective and subjective measures of aerobic performance.

Methods

We recruited two groups: patients with colorectal cancer (n = 30, 65.3 (51–77) y, body mass index 27.67 (4.83) kg m−2) and matched controls (n = 30, 64.6 (42–77) y, BMI 27.14 (3.51) kg m−2). Controls underwent a single study while colorectal cancer patients were studied before and 10 months after tumour resection. Aerobic performance was assessed via cardiopulmonary exercise testing and activity questionnaires. Lean muscle mass was measured via dual-energy X-ray absorptiometry.

Results

Lean muscle mass was not different between groups (control: 47.82 (8.23); pre-resection: 52.41 (10.59); post-resection: 52.38 (10.52), kg). Anaerobic threshold was lower in pre-operative patients compared to controls (14.40 (3.23) vs. 19.67 (5.81) ml kg−1 min−1, p < 0.0001), increasing significantly post-resection (17.00 (3.56) ml kg−1 min−1 p < 0.0001). Self reported maximal physical activity was lower after resection compared to preoperatively (pre-resection 6.0 (6.5–5 IQR), post-resection 3.75 (4–3 IQR), p < 0.0001).

Conclusion

In colorectal cancer, anaerobic threshold is reached more rapidly than in matched controls, returning toward normal with tumour resection. Self-reported measures of activity do not mirror this objective change, cardiopulmonary exercise testing may therefore allow for a more accurate evaluation of pre and postoperative performance capability. The variance between objective and subjective measures of exercise capacity may be important in determining return to normal activities.

Item Type: Article
Keywords: Surgery; Aerobic performance; Colorectal cancer
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Life Sciences > School of Biomedical Sciences
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Medical Sciences and Graduate Entry Medicine
Identification Number: 10.1016/j.ejso.2013.11.009
Depositing User: Eprints, Support
Date Deposited: 01 Aug 2017 10:35
Last Modified: 17 Oct 2017 06:34
URI: http://eprints.nottingham.ac.uk/id/eprint/44545

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