Esophageal and gastric cancer
Publicado 21/02/2018 Por Flávio Sabino
CIRURGIAS PARA CÂNCER DO ESÔFAGO E ESTÔMAGO
Linha de emergência
The Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary exercise testing (CPET) can assess preoperative fitness.
This study aims to investigate their correlation with both postoperative respiratory complications and overall survival.
Patients were identified who underwent esophageal or gastric resections for cancer between 2010 and 2014 and had ISWT and/or CPET assessments. Tumor differentiation, stage, postoperative respiratory complications, and outcome were documented and then correlated with the results of the preoperative fitness assessments.
However, ISWT (p < 0.001), AT (p < 0.001) and VO2 Max (p < 0.001) all correlated strongly with overall survival.
No patient with a score of less than 350 m on ISWT survived beyond 3 years.
In a subset of patients with ISWT results both pre and post chemotherapy (n = 49), those that had an improvement in result had a 19% incidence of post-operative respiratory complications compared to 45% where the result did not change or declined, though due to small numbers this only approached significance (p = 0.08).
ISWT and CPET can be useful preoperative tools to predict overall survival to for patients undergoing esophago-gastric resection.
Furthermore, patients that improve their functional status during chemotherapy seem to do better than those where it remains static or declines.