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 M. Saxton

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose Strategies to improve pre-operative cardiopulmonary fitness could positively impact recovery after surgery. Thisstudy investigated the feasibility of vigorous intensity aerobic interval exercise in bladder cancer patients prior to radicalcystectomy (RC).Methods A total of 60 patients were randomised (1:1) to exercise or control following a cardiopulmonary exercise test (CPET).The exercise group was offered twice-weekly pre-operative supervised vigorous intensity aerobic interval exercise in addition tostandard treatment. The controls received standard treatment only. A repeat CPET was undertaken before surgery and postoperative recovery outcomes were recorded.Results Over half of the 112 eligible patients approached in the clinic were recruited to the study (53.5%), with recruited patientsattending a median of 8 (range 1–10) exercise sessions over a pre-operative period of 3–6 weeks. Improvements in peak values ofoxygen pulse (P = 0.001), minute ventilation (P = 0.002) and power output (P < 0.001) were observed at the follow-up CPET inthe exercise group versus controls and there were no adverse events. Although this feasibility study was not powered to detectchanges in post-operative recovery outcomes, there were marginal (non-significant) differences in favour of the exercise group inpost-operative Clavien-Dindo score and need for high dependency unit inotropic support.Conclusions Bladder cancer patients respond well to pre-surgical aerobic interval exercise, and the improvements in cardiopulmonary fitness variables could have important implications for post-operative recuperation after RC. These findings provide astrong foundation for an adequately powered randomised controlled trial.
LanguageEnglish
JournalSupportive Care in Cancer
Early online date27 Nov 2017
DOIs
Publication statusE-pub ahead of print - 27 Nov 2017

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Cystectomy
Urinary Bladder Neoplasms
Randomized Controlled Trials
Exercise
Exercise Test
Feasibility Studies
Ventilation
Pulse
Control Groups
Therapeutics

Keywords

  • pre-operative care
  • exercise
  • urinary bladder neoplasms

Cite this

Banerjee, Srijit ; Manley, Kate ; Shaw, Barnabas ; Lewis, Liane ; Cucato, Gabriel ; Mills, Robert ; Rochester, Mark ; Clark, Allan ; Saxton, John M. / Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial. In: Supportive Care in Cancer. 2017.
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title = "Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial",
abstract = "Purpose Strategies to improve pre-operative cardiopulmonary fitness could positively impact recovery after surgery. Thisstudy investigated the feasibility of vigorous intensity aerobic interval exercise in bladder cancer patients prior to radicalcystectomy (RC).Methods A total of 60 patients were randomised (1:1) to exercise or control following a cardiopulmonary exercise test (CPET).The exercise group was offered twice-weekly pre-operative supervised vigorous intensity aerobic interval exercise in addition tostandard treatment. The controls received standard treatment only. A repeat CPET was undertaken before surgery and postoperative recovery outcomes were recorded.Results Over half of the 112 eligible patients approached in the clinic were recruited to the study (53.5{\%}), with recruited patientsattending a median of 8 (range 1–10) exercise sessions over a pre-operative period of 3–6 weeks. Improvements in peak values ofoxygen pulse (P = 0.001), minute ventilation (P = 0.002) and power output (P < 0.001) were observed at the follow-up CPET inthe exercise group versus controls and there were no adverse events. Although this feasibility study was not powered to detectchanges in post-operative recovery outcomes, there were marginal (non-significant) differences in favour of the exercise group inpost-operative Clavien-Dindo score and need for high dependency unit inotropic support.Conclusions Bladder cancer patients respond well to pre-surgical aerobic interval exercise, and the improvements in cardiopulmonary fitness variables could have important implications for post-operative recuperation after RC. These findings provide astrong foundation for an adequately powered randomised controlled trial.",
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Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial. / Banerjee, Srijit; Manley, Kate ; Shaw, Barnabas ; Lewis, Liane; Cucato, Gabriel; Mills, Robert ; Rochester, Mark; Clark, Allan; Saxton, John M.

In: Supportive Care in Cancer, 27.11.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial

AU - Banerjee, Srijit

AU - Manley, Kate

AU - Shaw, Barnabas

AU - Lewis, Liane

AU - Cucato, Gabriel

AU - Mills, Robert

AU - Rochester, Mark

AU - Clark, Allan

AU - Saxton, John M.

N1 - This is a post-peer-review, pre-copyedit version of an article published in Supportive Care in Cancer. The final authenticated version is available online at: https://doi.org/10.1007/s00520-017-3991-2

PY - 2017/11/27

Y1 - 2017/11/27

N2 - Purpose Strategies to improve pre-operative cardiopulmonary fitness could positively impact recovery after surgery. Thisstudy investigated the feasibility of vigorous intensity aerobic interval exercise in bladder cancer patients prior to radicalcystectomy (RC).Methods A total of 60 patients were randomised (1:1) to exercise or control following a cardiopulmonary exercise test (CPET).The exercise group was offered twice-weekly pre-operative supervised vigorous intensity aerobic interval exercise in addition tostandard treatment. The controls received standard treatment only. A repeat CPET was undertaken before surgery and postoperative recovery outcomes were recorded.Results Over half of the 112 eligible patients approached in the clinic were recruited to the study (53.5%), with recruited patientsattending a median of 8 (range 1–10) exercise sessions over a pre-operative period of 3–6 weeks. Improvements in peak values ofoxygen pulse (P = 0.001), minute ventilation (P = 0.002) and power output (P < 0.001) were observed at the follow-up CPET inthe exercise group versus controls and there were no adverse events. Although this feasibility study was not powered to detectchanges in post-operative recovery outcomes, there were marginal (non-significant) differences in favour of the exercise group inpost-operative Clavien-Dindo score and need for high dependency unit inotropic support.Conclusions Bladder cancer patients respond well to pre-surgical aerobic interval exercise, and the improvements in cardiopulmonary fitness variables could have important implications for post-operative recuperation after RC. These findings provide astrong foundation for an adequately powered randomised controlled trial.

AB - Purpose Strategies to improve pre-operative cardiopulmonary fitness could positively impact recovery after surgery. Thisstudy investigated the feasibility of vigorous intensity aerobic interval exercise in bladder cancer patients prior to radicalcystectomy (RC).Methods A total of 60 patients were randomised (1:1) to exercise or control following a cardiopulmonary exercise test (CPET).The exercise group was offered twice-weekly pre-operative supervised vigorous intensity aerobic interval exercise in addition tostandard treatment. The controls received standard treatment only. A repeat CPET was undertaken before surgery and postoperative recovery outcomes were recorded.Results Over half of the 112 eligible patients approached in the clinic were recruited to the study (53.5%), with recruited patientsattending a median of 8 (range 1–10) exercise sessions over a pre-operative period of 3–6 weeks. Improvements in peak values ofoxygen pulse (P = 0.001), minute ventilation (P = 0.002) and power output (P < 0.001) were observed at the follow-up CPET inthe exercise group versus controls and there were no adverse events. Although this feasibility study was not powered to detectchanges in post-operative recovery outcomes, there were marginal (non-significant) differences in favour of the exercise group inpost-operative Clavien-Dindo score and need for high dependency unit inotropic support.Conclusions Bladder cancer patients respond well to pre-surgical aerobic interval exercise, and the improvements in cardiopulmonary fitness variables could have important implications for post-operative recuperation after RC. These findings provide astrong foundation for an adequately powered randomised controlled trial.

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KW - urinary bladder neoplasms

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DO - 10.1007/s00520-017-3991-2

M3 - Article

JO - Supportive Care in Cancer

T2 - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

ER -