Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial

Srijit Banerjee, Kate Manley, Barnabas Shaw, Liane Lewis, Gabriel Cucato, Robert Mills, Mark Rochester, Allan Clark, John Saxton

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Abstract

Purpose: Strategies to improve pre-operative cardiopulmonary fitness could positively impact recovery aftersurgery. This study investigated the feasibility of pre-operative vigorous intensity aerobic interval exercise inbladder cancer patients prior to radical cystectomy (RC). Methods: A total of 60 patients were randomised (1:1)to an exercise or control group following a cardiopulmonary exercise test (CPET). The exercise group wasoffered twice-weekly pre-operative supervised vigorous intensity aerobic interval exercise in addition tostandard treatment, whilst the controls received standard treatment only. A repeat CPET was undertaken beforesurgery and post-operative recovery outcomes were recorded. Results: Over half of the 112 eligible patientsapproached in the clinic were recruited to the study (53.5%), with 52 of the 60 recruited patients (87%)attending both pre-operative CPETs and post-operative recovery data being available for 55 of the patients(92%). Patients attended a median of 8 (range: 1-10) exercise sessions over a pre-operative period of 3-6 weeks.Improvements in peak values of oxygen pulse (P=0.001), minute ventilation (P=0.002) and power output(P<0.001) were observed at the follow-up CPET in the exercise group versus controls and there were no adverseevents. Although this feasibility study was not powered to detect changes in post-operative recovery outcomes,there were marginal (non-significant) differences in favour of the exercise group in post-operative Clavien-Dindo score and need for High Dependency Unit inotropic support. Conclusions: Vigorous intensity aerobicinterval exercise could be an effective strategy for improving pre-operative physiological reserve and postoperativerecovery outcomes in bladder cancer patients undergoing RC. Implications for Cancer Survivors:Bladder cancer patients respond well to pre-surgical interval exercise and the improvements in cardiopulmonaryfitness variables could have important implications for post-operative recuperation after RC.
Original languageEnglish
Pages (from-to)1515–1523
Number of pages9
JournalJournal of Supportive Care in Cancer
Volume26
Issue number5
Early online date27 Nov 2017
DOIs
Publication statusPublished - May 2018

Keywords

  • Pre-operative care
  • Exercise
  • Urinary bladder neoplasms

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