John P. Williams
Surgical resection of primary tumour improves aerobic performance in colorectal cancer
Williams, John P.; Nyasavajjala, Sitaramachandra M.; Phillips, Beth E.; Chakrabarty, M.; Lund, Jonathan N.
Sitaramachandra M. Nyasavajjala
Beth E. Phillips
Jonathan N. Lund
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.
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.
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).
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.
|Journal Article Type||Article|
|Publication Date||Feb 1, 2014|
|Journal||European Journal of Surgical Oncology (EJSO)|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||Williams, J. P., Nyasavajjala, S. M., Phillips, B. E., Chakrabarty, M., & Lund, J. N. (2014). Surgical resection of primary tumour improves aerobic performance in colorectal cancer. EJSO - European Journal of Surgical Oncology, 40(2), doi:10.1016/j.ejso.2013.11.009|
|Keywords||Surgery; Aerobic performance; Colorectal cancer|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf|
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