Association of Preoperative Physical Fitness With Post-Esophagectomy Pneumonia in Older With Locally Advanced Esophageal Cancer: An Exploratory Prospective Study
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])
Search for more papers by this authorTetsuya Tsuji
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
Search for more papers by this authorJunya Ueno
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorNobuko Konishi
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorTakumi Yanagisawa
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorNanako Hijikata
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorAiko Ishikawa
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
Search for more papers by this authorKakeru Hashimoto
Department of Rehabilitation, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorHitoshi Kagaya
Department of Rehabilitation, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorNoriatsu Tatematsu
Department of Integrated Health Sciences, Nagoya University, Nagoya, Japan
Search for more papers by this authorSadamoto Zenda
Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorDaisuke Kotani
Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorTakashi Kojima
Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorTakeo Fujita
Department of Esophageal Surgery, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorCorresponding 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])
Search for more papers by this authorTetsuya Tsuji
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
Search for more papers by this authorJunya Ueno
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorNobuko Konishi
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorTakumi Yanagisawa
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorNanako Hijikata
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorAiko Ishikawa
Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba, Japan
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
Search for more papers by this authorKakeru Hashimoto
Department of Rehabilitation, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorHitoshi Kagaya
Department of Rehabilitation, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorNoriatsu Tatematsu
Department of Integrated Health Sciences, Nagoya University, Nagoya, Japan
Search for more papers by this authorSadamoto Zenda
Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorDaisuke Kotani
Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorTakashi Kojima
Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorTakeo Fujita
Department of Esophageal Surgery, National Cancer Center Hospital East, Chiba, Japan
Search for more papers by this authorABSTRACT
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.
Open Research
Data Availability Statement
The authors have nothing to report.
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