PMID- 29459017 OWN - NLM STAT- MEDLINE DCOM- 20180620 LR - 20180620 IS - 1532-2157 (Electronic) IS - 0748-7983 (Linking) VI - 44 IP - 5 DP - 2018 May TI - Poor performance in incremental shuttle walk and cardiopulmonary exercise testing predicts poor overall survival for patients undergoing esophago-gastric resection. PG - 594-599 LID - S0748-7983(18)30291-9 [pii] LID - 10.1016/j.ejso.2018.01.242 [doi] AB - INTRODUCTION: Esophageal and gastric cancer have a poor prognosis and surgical intervention is associated with considerable morbidity, highlighting the need for careful preoperative assessment. 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 AND METHODS: 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. RESULTS: Neither the ISWT result, anaerobic threshold (AT) nor VO2 Max correlated well with perioperative complications. 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). CONCLUSION: ISWT and CPET can be useful preoperative tools to predict overall survival 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. CI - Copyright (c) 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. FAU - Whibley, Jessica AU - Whibley J AD - Department of Physiotherapy, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK. Electronic address: Jessica.whibley@rmh.nhs.uk. FAU - Peters, Christopher J AU - Peters CJ AD - Department of Surgery & Cancer, Imperial College London, St Mary's Hospital, Praed Street, London, W2 1NY, UK. Electronic address: Christopher.peters@imperial.ac.uk. FAU - Halliday, Laura J AU - Halliday LJ AD - Department of Surgery & Cancer, Imperial College London, St Mary's Hospital, Praed Street, London, W2 1NY, UK. Electronic address: Laura.halliday15@imperial.ac.uk. FAU - Chaudry, Asif M AU - Chaudry AM AD - Academic Department of Surgery, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK. Electronic address: Asif.chaudry@rmh.nhs.uk. FAU - Allum, William H AU - Allum WH AD - Academic Department of Surgery, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK. Electronic address: william.allum@rmh.nhs.uk. LA - eng PT - Journal Article DEP - 20180206 PL - England TA - Eur J Surg Oncol JT - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JID - 8504356 SB - IM MH - Adenocarcinoma/pathology/*surgery MH - Adult MH - Aged MH - Aged, 80 and over MH - Esophageal Neoplasms/pathology/*surgery MH - *Esophagectomy MH - *Exercise Test MH - *Exercise Tolerance MH - Female MH - *Gastrectomy MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Neoplasm Staging MH - Postoperative Complications/*epidemiology MH - Prognosis MH - Respiratory Tract Diseases/*epidemiology MH - Stomach Neoplasms/pathology/*surgery MH - Survival Rate MH - Walk Test OTO - NOTNLM OT - Esophageal neoplasms OT - Exercise test OT - Exercise tolerance OT - Postoperative complications OT - Preoperative care OT - Prognosis OT - Stomach neoplasms OT - Survival OT - Survival rate EDAT- 2018/02/21 06:00 MHDA- 2018/06/21 06:00 CRDT- 2018/02/21 06:00 PHST- 2017/05/16 00:00 [received] PHST- 2017/11/27 00:00 [revised] PHST- 2018/01/30 00:00 [accepted] PHST- 2018/02/21 06:00 [pubmed] PHST- 2018/06/21 06:00 [medline] PHST- 2018/02/21 06:00 [entrez] AID - S0748-7983(18)30291-9 [pii] AID - 10.1016/j.ejso.2018.01.242 [doi] PST - ppublish SO - Eur J Surg Oncol. 2018 May;44(5):594-599. doi: 10.1016/j.ejso.2018.01.242. Epub 2018 Feb 6.