Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
Impact of exercise-based prehabilitation on cardiometabolic health in surgical patients with cancer: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Fernandez-Escabias Manuel, Jurado Javier, Carrilho-Candeias Sofia, Orellana-Jaen Andrea, Corres Pablo, Marmol-Perez Andres, Lavie Carl J, Carneiro-Barrera Almudena, Nestares Teresa, Amaro-Gahete Francisco J
Аннотация
OBJECTIVE: This systematic review and meta-analysis aimed to establish the effects of exercise-based prehabilitation programs on cardiometabolic health in patients with cancer undergoing surgery.
DATA SOURCE: A systematic search was conducted in MEDLINE (via PubMed) and Web of Science from inception to June 2023.
STUDY SELECTION: The original systematic search retrieved 16,752 studies. After removal of duplicates and screening by title and abstract, 200 articles were eligible for full-text revision. Finally, a total of nine randomized controlled trials (RCTs), four controlled studies, and six uncontrolled before-and-after studies were included.
OUTCOME MEASURES: Changes in blood pressure (systolic and diastolic), lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides levels), glycemic metabolism (fasting glucose, insulin, homeostatic model assessment for insulin resistance, and insulin-growth factor-1), and inflammatory biomarkers (i.e., interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and vascular endothelial growth factor) were assessed.
RESULTS: The total sample was composed of 651 participants (n = 311 intervention and n = 239 control from RCTs and controlled studies; n = 101 intervention from before-and-after studies), aged 64.90 ± 8.87 years (33.76% women). The meta-analyses of uncontrolled before-and-after studies revealed significant prehabilitation-induced reductions in systolic and diastolic blood pressure (d = - 0.47 and - 0.57, respectively). However, no changes were noted in lipid and glycemic metabolism or inflammatory biomarkers in either controlled or uncontrolled before-and-after studies.
LIMITATIONS: These findings should be interpreted with caution. The small evidence base, inclusion of uncontrolled designs, substantial between-study heterogeneity, and the possibility of publication bias limit the robustness and generalizability of the conclusions.
CONCLUSIONS: Exercise-based prehabilitation programs seems to be effective at reducing blood pressure in patients with cancer undergoing surgery. No effects were noted in other cardiometabolic health outcomes included.
DATA SOURCE: A systematic search was conducted in MEDLINE (via PubMed) and Web of Science from inception to June 2023.
STUDY SELECTION: The original systematic search retrieved 16,752 studies. After removal of duplicates and screening by title and abstract, 200 articles were eligible for full-text revision. Finally, a total of nine randomized controlled trials (RCTs), four controlled studies, and six uncontrolled before-and-after studies were included.
OUTCOME MEASURES: Changes in blood pressure (systolic and diastolic), lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides levels), glycemic metabolism (fasting glucose, insulin, homeostatic model assessment for insulin resistance, and insulin-growth factor-1), and inflammatory biomarkers (i.e., interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and vascular endothelial growth factor) were assessed.
RESULTS: The total sample was composed of 651 participants (n = 311 intervention and n = 239 control from RCTs and controlled studies; n = 101 intervention from before-and-after studies), aged 64.90 ± 8.87 years (33.76% women). The meta-analyses of uncontrolled before-and-after studies revealed significant prehabilitation-induced reductions in systolic and diastolic blood pressure (d = - 0.47 and - 0.57, respectively). However, no changes were noted in lipid and glycemic metabolism or inflammatory biomarkers in either controlled or uncontrolled before-and-after studies.
LIMITATIONS: These findings should be interpreted with caution. The small evidence base, inclusion of uncontrolled designs, substantial between-study heterogeneity, and the possibility of publication bias limit the robustness and generalizability of the conclusions.
CONCLUSIONS: Exercise-based prehabilitation programs seems to be effective at reducing blood pressure in patients with cancer undergoing surgery. No effects were noted in other cardiometabolic health outcomes included.