Surgical resection of primary tumour improves aerobic performance in colorectal cancer

Background Colorectal cancer is the third most common cancer in the UK, with patients suffering declines in muscle mass and aerobic function. We hypothesised that tumour removal in non-metastatic colorectal cancer would lead to a restoration of lean muscle mass and increases in objective and subj...

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Main Authors: Williams, John P., Nyasavajjala, Sitaramachandra M., Phillips, Beth E., Chakrabarty, M., Lund, Jonathan N.
Format: Article
Published: Elsevier 2014
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Online Access:https://eprints.nottingham.ac.uk/44545/
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author Williams, John P.
Nyasavajjala, Sitaramachandra M.
Phillips, Beth E.
Chakrabarty, M.
Lund, Jonathan N.
author_facet Williams, John P.
Nyasavajjala, Sitaramachandra M.
Phillips, Beth E.
Chakrabarty, M.
Lund, Jonathan N.
author_sort Williams, John P.
building Nottingham Research Data Repository
collection Online Access
description Background Colorectal cancer is the third most common cancer in the UK, with patients suffering declines in muscle mass and aerobic function. We hypothesised that tumour removal in non-metastatic colorectal cancer would lead to a restoration of lean muscle mass and increases in objective and subjective measures of aerobic performance. Methods We recruited two groups: patients with colorectal cancer (n = 30, 65.3 (51–77) y, body mass index 27.67 (4.83) kg m−2) and matched controls (n = 30, 64.6 (42–77) y, BMI 27.14 (3.51) kg m−2). Controls underwent a single study while colorectal cancer patients were studied before and 10 months after tumour resection. Aerobic performance was assessed via cardiopulmonary exercise testing and activity questionnaires. Lean muscle mass was measured via dual-energy X-ray absorptiometry. Results Lean muscle mass was not different between groups (control: 47.82 (8.23); pre-resection: 52.41 (10.59); post-resection: 52.38 (10.52), kg). Anaerobic threshold was lower in pre-operative patients compared to controls (14.40 (3.23) vs. 19.67 (5.81) ml kg−1 min−1, p < 0.0001), increasing significantly post-resection (17.00 (3.56) ml kg−1 min−1 p < 0.0001). Self reported maximal physical activity was lower after resection compared to preoperatively (pre-resection 6.0 (6.5–5 IQR), post-resection 3.75 (4–3 IQR), p < 0.0001). Conclusion In colorectal cancer, anaerobic threshold is reached more rapidly than in matched controls, returning toward normal with tumour resection. Self-reported measures of activity do not mirror this objective change, cardiopulmonary exercise testing may therefore allow for a more accurate evaluation of pre and postoperative performance capability. The variance between objective and subjective measures of exercise capacity may be important in determining return to normal activities.
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spelling nottingham-445452020-05-04T20:15:39Z https://eprints.nottingham.ac.uk/44545/ Surgical resection of primary tumour improves aerobic performance in colorectal cancer Williams, John P. Nyasavajjala, Sitaramachandra M. Phillips, Beth E. Chakrabarty, M. Lund, Jonathan N. Background Colorectal cancer is the third most common cancer in the UK, with patients suffering declines in muscle mass and aerobic function. We hypothesised that tumour removal in non-metastatic colorectal cancer would lead to a restoration of lean muscle mass and increases in objective and subjective measures of aerobic performance. Methods We recruited two groups: patients with colorectal cancer (n = 30, 65.3 (51–77) y, body mass index 27.67 (4.83) kg m−2) and matched controls (n = 30, 64.6 (42–77) y, BMI 27.14 (3.51) kg m−2). Controls underwent a single study while colorectal cancer patients were studied before and 10 months after tumour resection. Aerobic performance was assessed via cardiopulmonary exercise testing and activity questionnaires. Lean muscle mass was measured via dual-energy X-ray absorptiometry. Results Lean muscle mass was not different between groups (control: 47.82 (8.23); pre-resection: 52.41 (10.59); post-resection: 52.38 (10.52), kg). Anaerobic threshold was lower in pre-operative patients compared to controls (14.40 (3.23) vs. 19.67 (5.81) ml kg−1 min−1, p < 0.0001), increasing significantly post-resection (17.00 (3.56) ml kg−1 min−1 p < 0.0001). Self reported maximal physical activity was lower after resection compared to preoperatively (pre-resection 6.0 (6.5–5 IQR), post-resection 3.75 (4–3 IQR), p < 0.0001). Conclusion In colorectal cancer, anaerobic threshold is reached more rapidly than in matched controls, returning toward normal with tumour resection. Self-reported measures of activity do not mirror this objective change, cardiopulmonary exercise testing may therefore allow for a more accurate evaluation of pre and postoperative performance capability. The variance between objective and subjective measures of exercise capacity may be important in determining return to normal activities. Elsevier 2014-02 Article PeerReviewed Williams, John P., Nyasavajjala, Sitaramachandra M., Phillips, Beth E., Chakrabarty, M. and Lund, Jonathan N. (2014) Surgical resection of primary tumour improves aerobic performance in colorectal cancer. European Journal of Surgical Oncology (EJSO), 40 (2). pp. 220-226. ISSN 0748-7983 Surgery; Aerobic performance; Colorectal cancer http://www.sciencedirect.com/science/article/pii/S0748798313009177?via%3Dihub doi:10.1016/j.ejso.2013.11.009 doi:10.1016/j.ejso.2013.11.009
spellingShingle Surgery; Aerobic performance; Colorectal cancer
Williams, John P.
Nyasavajjala, Sitaramachandra M.
Phillips, Beth E.
Chakrabarty, M.
Lund, Jonathan N.
Surgical resection of primary tumour improves aerobic performance in colorectal cancer
title Surgical resection of primary tumour improves aerobic performance in colorectal cancer
title_full Surgical resection of primary tumour improves aerobic performance in colorectal cancer
title_fullStr Surgical resection of primary tumour improves aerobic performance in colorectal cancer
title_full_unstemmed Surgical resection of primary tumour improves aerobic performance in colorectal cancer
title_short Surgical resection of primary tumour improves aerobic performance in colorectal cancer
title_sort surgical resection of primary tumour improves aerobic performance in colorectal cancer
topic Surgery; Aerobic performance; Colorectal cancer
url https://eprints.nottingham.ac.uk/44545/
https://eprints.nottingham.ac.uk/44545/
https://eprints.nottingham.ac.uk/44545/