Preoperative exercise training for patients with non‐small cell lung cancer

Vinicius Cavalheri; Catherine Granger

doi:10.1002/14651858.CD012020.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Figure 1

Flow diagram of references identified, excluded, and included in review

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 4

Forest plot of comparison: 1 Intervention group versus control group, outcome: 1.1 Risk of developing a postoperative pulmonary complication.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 5

Forest plot of comparison: 1 Intervention group versus control group, outcome: 1.2 Number of days patients needed an intercostal catheter.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 6

Forest plot of comparison: 1 Intervention group versus control group, outcome: 1.3 Postoperative length of hospital stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Intervention group versus control group, Outcome 1 Risk of developing a postoperative pulmonary complication.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Intervention group versus control group, Outcome 2 Number of days patients needed an intercostal catheter.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Intervention group versus control group, Outcome 3 Postoperative length of hospital stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Intervention group versus control group, Outcome 4 Preoperative exercise capacity (6‐minute walk distance).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Intervention group versus control group, Outcome 5 Forced vital capacity (% pred).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Summary of findings for the main comparison. Preoperative exercise training compared to no exercise training for patients scheduled to undergo lung resection for non‐small cell lung cancer

Preoperative exercise training compared to no exercise training for patients scheduled to undergo lung resection for non‐small cell lung cancer
Patient or population: patients scheduled to undergo lung resection for non‐small cell lung cancer Setting: the studies were based in the USA, China, Brazil, Turkey, and Italy. Intervention: preoperative exercise training Comparison: no exercise training
Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Quality of the evidence (GRADE)	Comments
	Risk with no exercise training	Risk with preoperative exercise training
Number of patients who developed postoperative pulmonary complications	Study population		RR 0.33 (0.17 to 0.61)	158 (4 RCTs)	⊕⊕⊝⊝ LOW ^{1, 2}
	22 per 100	7 per 100 (4 to 13)
Number of days patients needed an intercostal catheter	The mean number of days patients needed an intercostal catheter in the control groups ranged from 7.4 to 8.8 days	The number of days patients needed an intercostal catheter in the intervention groups was, on average, 3.33 fewer days (95% CI 5.35 to 1.3 fewer days)	‐	38 (2 RCTs)	⊕⊕⊝⊝ LOW ^{1, 2}
Postoperative length of hospital stay	The mean postoperative length of hospital stay in the control groups ranged from 9.7 to 12.2 days	The postoperative length of hospital stay in the intervention groups was, on average, 4.34 fewer days (95% CI 5.65 to 3.03 fewer days)	‐	158 (4 RCTs)	⊕⊕⊝⊝ LOW ^{1, 2}
Post‐intervention exercise capacity assessed with: 6‐minute walk distance (6MWD)	The mean post‐intervention exercise capacity in the control groups ranged from 340 to 434 metres in 6 minutes.	The post‐intervention exercise capacity in the intervention groups was, on average, 18.23 metres more (95% CI 8.5 to 27.96 metres more)	‐	81 (2 RCTs)	⊕⊕⊝⊝ LOW ^{1, 2}
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio;
GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
¹ Significant risk of bias across the studies ² Small sample sizes across the studies, some with wide confidence intervals

Summary of findings for the main comparison. Preoperative exercise training compared to no exercise training for patients scheduled to undergo lung resection for non‐small cell lung cancer

Ir a la tabla de la revisión

Table 1. Table 1. Results of included studies

Study	Results
Benzo 2011	Number of patients who developed a postoperative pulmonary complication: Intervention group (IG): 3 of 9 (33%) Control Group (CG): 5 of 8 (63%) P = 0.23 (between‐group) Number of days patients needed a chest tube: IG: 4.3 ± 2.1 days CG: 8.8 ± 5.3 days P = 0.03 (between‐group) Postoperative length of hospital stay: IG: 6.3 ± 3.0 days CG: 11.0 ± 6.3 days P = 0.058 (between‐group)
Lai 2017	Number of patients who developed a postoperative pulmonary complication: IG: 4 of 30 (13%) CG: 11 of 30 (37%) P = 0.037 (between‐group) Postoperative length of hospital stay: IG: 6.9 ± 4.4 days CG: 10.7 ± 6.4 days P = 0.01 (between‐group) Exercise capacity: Six‐Minute Walk Distance (6MWD), in metres: IG: 30 participants completed; CG: 30 participants completed; Preoperative measurements: baseline and post‐intervention: Mean ± standard deviation (SD): IG: 431.7 ± 102.8 m to 460.3 ± 93.6 m; CG: 434.5 ± 86.2 m to 443.9 ± 88.4 m P = 0.029 (between‐group)
Morano 2013	Number of patients who developed a postoperative pulmonary complication: IG: 2 of 12 (17%) CG: 7 of 9 (78%) P = 0.01 (between‐group) Number of days patients needed a chest tube: IG: 4.5 ± 2.9 days CG: 7.4 ± 2.6 days P = 0.03 (between‐group) Postoperative length of hospital stay: IG: 7.8 ± 4.8 days CG: 12.2 ± 3.6 days P = 0.04 (between‐group) Exercise capacity: Six‐Minute Walk Distance (6MWD), in metres: IG: 12 participants completed; CG: 12 participants completed; Preoperative measurements: baseline and post‐intervention: Mean ± standard deviation (SD): IG: 425.5 ± 85.3 m to 475 ± 86.5 m (P < 0.01); CG: 339.6 ± 107 m to 335 ± 107 m (P > 0.05) P < 0.001 (between‐group) Lung function: (i) Forced expired volume in one second (FEV₁; % predicted): IG: 12 participants completed; CG: 12 participants completed; Preoperative measurements: baseline and post‐intervention: IG: 48.1 ± 13.9% to 54.8 ± 22.4% (P = 0.08); CG: 51.7 ± 9.8% to 58.8 ± 13.0% (P = 0.23) Between‐group difference was not calculated (ii) Forced vital capacity (FVC; % predicted): IG: 12 participants completed; CG: 12 participants completed; Preoperative measurements: baseline and post‐intervention: Median (interquartile range): IG: 62.5% (49 to 71) to 76% (65 to 79.7); P = 0.02; CG: 62.5% (56 to 92) to 71% (63.2 to 89); P = 0.37 Between‐group difference was not calculated
Pehlivan 2011	Number of patients who developed a postoperative pulmonary complication: IG: 1 of 30 (3%) CG: 5 of 30 (17%) P = 0.04 (between‐group) Postoperative length of hospital stay: IG: 5.4 ± 2.7 days CG: 9.7 ± 3.1 days P < 0.001 (between‐group) Lung function: (i) FEV₁; % predicted: IG: 30 participants completed; CG: 30 participants completed; Preoperative measurements: change from baseline to post‐intervention: IG: 15.84 ± 2.10%; CG: 9.92 ± 3.5% P = 0.3 (between‐group) (ii) FVC; % predicted: IG: 30 participants completed; CG: 30 participants completed; Preoperative measurements: baseline and post‐intervention: IG: 19.26 ± 2.33%; CG: 16.3 ± 2.4% P = 0.6 (between‐group)
Stefanelli 2013	Exercise capacity: Peak rate of oxygen uptake (VO_2peak), in ml/kg/min: IG: 20 participants completed; CG: 20 participants completed; Preoperative measurements: baseline and post‐intervention: IG: 14.9 ± 2.3 ml/kg/min to 17.8 ± 2.1 ml/kg/min; CG: 14.8 ± 1.4 ml/kg/min to 14.5 ± 1.2 ml/kg/min P < 0.001 (between‐group) Lung function: FEV₁; % predicted: IG: 20 participants completed; CG: 20 participants completed; Preoperative measurements: baseline and post‐intervention: IG: 57.4 ± 19.1% to 59.8 ± 19.2%; CG: 57.6 ± 16.9% to 57.5 ± 17.0% P > 0.05 (between‐group)
Intervention group (IG), Control Group (CG)

Table 1. Table 1. Results of included studies

Ir a la tabla de la revisión

Comparison 1. Intervention group versus control group

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Risk of developing a postoperative pulmonary complication Show forest plot	4	158	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.17, 0.61]

2 Number of days patients needed an intercostal catheter Show forest plot	2	38	Mean Difference (IV, Fixed, 95% CI)	‐3.33 [‐5.35, ‐1.30]

3 Postoperative length of hospital stay Show forest plot	4	158	Mean Difference (IV, Fixed, 95% CI)	‐4.24 [‐5.43, ‐3.06]

4 Preoperative exercise capacity (6‐minute walk distance) Show forest plot	2	81	Mean Difference (IV, Fixed, 95% CI)	18.23 [8.50, 27.96]

5 Forced vital capacity (% pred) Show forest plot	2	84	Mean Difference (IV, Fixed, 95% CI)	2.97 [1.78, 4.16]

Comparison 1. Intervention group versus control group

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet