Volume 131, Issue 7 pp. 1284-1292
RESEARCH ARTICLE

Association of Preoperative Physical Fitness With Post-Esophagectomy Pneumonia in Older With Locally Advanced Esophageal Cancer: An Exploratory Prospective Study

Tsuyoshi Harada

Corresponding Author

Tsuyoshi Harada

Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan

Department of Rehabilitation Medicine, Keio University Graduate School, Tokyo, Japan

Correspondence: Tsuyoshi Harada ([email protected])

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Tetsuya Tsuji

Tetsuya Tsuji

Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan

Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan

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Junya Ueno

Junya Ueno

Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan

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Nobuko Konishi

Nobuko Konishi

Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan

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Takumi Yanagisawa

Takumi Yanagisawa

Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan

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Nanako Hijikata

Nanako Hijikata

Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan

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Aiko Ishikawa

Aiko Ishikawa

Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan

Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan

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Kakeru Hashimoto

Kakeru Hashimoto

Department of Rehabilitation, National Center for Geriatrics and Gerontology, Aichi, Japan

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Hitoshi Kagaya

Hitoshi Kagaya

Department of Rehabilitation, National Center for Geriatrics and Gerontology, Aichi, Japan

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Noriatsu Tatematsu

Noriatsu Tatematsu

Department of Integrated Health Sciences, Nagoya University, Nagoya, Japan

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Sadamoto Zenda

Sadamoto Zenda

Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan

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Daisuke Kotani

Daisuke Kotani

Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan

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Takashi Kojima

Takashi Kojima

Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan

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Takeo Fujita

Takeo Fujita

Department of Esophageal Surgery, National Cancer Center Hospital East, Chiba, Japan

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First published: 29 December 2024
Citations: 2

ABSTRACT

Backgrounds

Currently, there is a lack of evidence of prehabilitation during neoadjuvant chemotherapy (NAC) to prevent pneumonia of older patients. This study aimed to investigate the association of preoperative physical fitness after NAC with post-esophagectomy pneumonia in older patients with locally advanced esophageal cancer (LAEC).

Methods

This single-center exploratory prospective cohort study included 80 patients aged ≥ 65 years with LAEC scheduled for curative esophagectomy after NAC between 2021 and 2023. The post-NAC short incremental shuttle walk test (ISWT) by sex was established using the Youden index. The association of the post-NAC short ISWT with postoperative pneumonia was investigated via Firth's penalized logistic regression model with statistical significance set as two-tailed p < 0.05.

Results

A total of 69 patients were analyzed. The mean post-NAC ISWT values were 353.5 m. Short ISWT distance was defined as ≤ 395 and ≤ 195 m for men and women, respectively. Postoperative pneumonia developed in 17 (25%) patients. Short post-NAC ISWT distance was significantly associated with postoperative pneumonia (adjusted odds ratio: 1.840, 95%CI: 1.760–28.440, p = 0.004).

Conclusions

Decline in physical fitness was associated with post-esophagectomy pneumonia, which may be a key targeted factor of prehabilitation during NAC for older patients with LAEC.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The authors have nothing to report.

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