Preoperative exercise training for people with non-small cell lung cancer

Catherine Granger, Vinicius Cavalheri, Catherine Granger, Vinicius Cavalheri

Abstract

Background: Surgical resection for early-stage non-small cell lung cancer (NSCLC) offers the best chance of cure, but it is associated with a risk of postoperative pulmonary complications. It is unclear if preoperative exercise training, and the potential resultant improvement in exercise capacity, may improve postoperative outcomes. This review updates our initial 2017 systematic review.

Objectives: 1. To evaluate the benefits and harm of preoperative exercise training on postoperative outcomes, such as the risk of developing a postoperative pulmonary complication and the postoperative duration of intercostal catheter, in adults scheduled to undergo lung resection for NSCLC. 2. To determine the effect on length of hospital stay (and costs associated with postoperative hospital stay), fatigue, dyspnoea, exercise capacity, lung function and postoperative mortality.

Search methods: We used standard, extensive Cochrane search methods. The latest search date was from 28 November 2016 to 23 November 2021.

Selection criteria: We included randomised controlled trials (RCTs) in which study participants who were scheduled to undergo lung resection for NSCLC were allocated to receive either preoperative exercise training or no exercise training.

Data collection and analysis: We used standard Cochrane methods. Our primary outcomes were 1. risk of developing a postoperative pulmonary complication; 2. postoperative duration of intercostal catheter and 3.

Safety: Our secondary outcomes were 1. postoperative length of hospital stay; 2. postintervention fatigue; 3. postintervention dyspnoea; 4. postintervention and postoperative exercise capacity; 5. postintervention lung function and 6. postoperative mortality. We used GRADE to assess the certainty of evidence for each outcome.

Main results: Along with the five RCTs included in the original version, we identified an additional five RCTs, resulting in 10 RCTs involving 636 participants. Preoperative exercise training results in a large reduction in the risk of developing a postoperative pulmonary complication compared to no preoperative exercise training (risk ratio (RR) 0.45, 95% CI 0.33 to 0.61; I2 = 0%; 9 studies, 573 participants; high-certainty evidence). The evidence is very uncertain about its effect on postoperative intercostal catheter duration (MD -2.07 days, 95% CI -4.64 to 0.49; I2 = 77%, 3 studies, 111 participants; very low-certainty evidence). Preoperative exercise training is likely safe as studies reported no adverse events. Preoperative exercise training likely results in a reduction in postoperative length of hospital stay (MD -2.24 days, 95% CI -3.64 to -0.85; I2 = 85%; 9 studies, 573 participants; moderate-certainty evidence). Preoperative exercise training likely increases postintervention exercise capacity measured by peak oxygen consumption (MD 3.36 mL/kg/minute, 95% CI 2.70 to 4.02; I2 = 0%; 2 studies, 191 participants; moderate-certainty evidence); but the evidence is very uncertain about its effect on postintervention exercise capacity measured by the 6-minute walk distance (MD 29.55 m, 95% CI 12.05 to 47.04; I2 = 90%; 6 studies, 474 participants; very low-certainty evidence). Preoperative exercise training may result in little to no effect on postintervention lung function (forced expiratory volume in one second: MD 5.87% predicted, 95% CI 4.46 to 7.28; I2 = 0%; 4 studies, 197 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: Preoperative exercise training results in a large reduction in the risk of developing a postoperative pulmonary complication compared to no preoperative exercise training for people with NSCLC. It may also reduce postoperative length of hospital stay, and improve exercise capacity and lung function in people undergoing lung resection for NSCLC. The findings of this review should be interpreted with caution due to risk of bias. Research investigating the cost-effectiveness and long-term outcomes associated with preoperative exercise training in NSCLC is warranted.

Conflict of interest statement

CG: none.

VC: none.

Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Figures

1
1
Flow diagram of references identified, excluded and included in review.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Forest plot of comparison: 1 Intervention group versus control group, outcome: 1.1 Risk of developing a postoperative pulmonary complication.
5
5
Forest plot of comparison: 1 Intervention group versus control group, outcome: 1.2 Number of days patients needed an intercostal catheter.
6
6
Forest plot of comparison: 1 Intervention group versus control group, outcome: 1.3 Postoperative length of hospital stay.
1.1. Analysis
1.1. Analysis
Comparison 1: Exercise versus no exercise, Outcome 1: Risk of developing a postoperative pulmonary complication
1.2. Analysis
1.2. Analysis
Comparison 1: Exercise versus no exercise, Outcome 2: Number of days participants needed an intercostal catheter following surgery
1.3. Analysis
1.3. Analysis
Comparison 1: Exercise versus no exercise, Outcome 3: Postoperative length of hospital stay (days)
1.4. Analysis
1.4. Analysis
Comparison 1: Exercise versus no exercise, Outcome 4: Postintervention (preoperative) dyspnoea (BORG scale)
1.5. Analysis
1.5. Analysis
Comparison 1: Exercise versus no exercise, Outcome 5: Postintervention (preoperative) exercise capacity (6‐minute walk distance in m)
1.6. Analysis
1.6. Analysis
Comparison 1: Exercise versus no exercise, Outcome 6: Postintervention (preoperative) exercise capacity (VO2peak in mL/kg/minute)
1.7. Analysis
1.7. Analysis
Comparison 1: Exercise versus no exercise, Outcome 7: Postoperative exercise capacity (6‐minute walk distance in m)
1.8. Analysis
1.8. Analysis
Comparison 1: Exercise versus no exercise, Outcome 8: Postintervention (preoperative) forced expiratory volume in 1 second (% predicted)
1.9. Analysis
1.9. Analysis
Comparison 1: Exercise versus no exercise, Outcome 9: Postintervention (preoperative) forced vital capacity (% predicted)
1.10. Analysis
1.10. Analysis
Comparison 1: Exercise versus no exercise, Outcome 10: Postintervention (preoperative) peak expiratory flow (L/minute)

References

References to studies included in this review Benzo 2011 {published data only}

    1. Benzo R, Wetztein M, Novotny P, Wigle D, Shen RS, Nichols F, et al. Randomized study of pulmonary rehabilitation before lung cancer resection in severe COPD. American Journal of Respiratory and Critical Care Medicine 2011;183:A3973.
    1. Benzo R, Wigle D, Novotny P, Wetztein M, Nichols F, Shen RS, et al. Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies. Lung Cancer 2011;74:441-5.
Garcia 2017 {published and unpublished data}
    1. Garcia RS, Paz AL, Brage MI, Moolhuyzen EG, Rioboo MS, Mate JM. Preliminary efficacy of preoperative exercise training in patients with lung malignancies undergoing VATS. European Respiratory Journal 2016;48(60):PA541. [DOI: 10.1183/13993003.congress-2016.PA541]
    1. Sebio García R, Yáñez-Brage MI, Giménez Moolhuyzen E, Salorio Riobo M, Lista Paz A, Borro Mate JM. Preoperative exercise training prevents functional decline after lung resection surgery: a randomized, single-blind controlled trial. Clinical Rehabilitation 2017;31(8):1057-67. [DOI: 10.1177/0269215516684179]
Lai 2017a {published data only}
    1. Lai Y, Huang J, Yang M, Su J, Liu J, Che G. Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial. Journal of Surgical Research 2017;209:30-6.
Lai 2017b {published data only (unpublished sought but not used)}
    1. Huang J, Lai Y, Zhou X, Li S, Su J, Yang M, Che G. Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial. Journal of thoracic disease 2017;9(7):1919-29. [DOI: 10.21037/jtd.2017.06.15]
    1. Lai Y, Su J, Qui P, Wang M, Zhou K, Tang Y, et al. Systematic short-term pulmonary rehabilitation before lung cancer lobectomy: a randomized trial. Interactive CardioVascular and Thoracic Surgery 2017;25(3):476-83. [DOI: 10.1093/icvts/ivx141]
    1. Lai Y, Su J, Yang M, Zhou K, Che G. Impact and effect of preoperative short-term pulmonary rehabilitation training on lung cancer patients with mild to moderate chronic obstructive pulmonary disease: a randomized trial. Chinese Journal of Lung Cancer 2016;19(11):746-54. [DOI: 10.3779/j.issn.1009-3419.2016.11.05]
    1. Wang X, Che G, Liu L. A short-term high-intensive pattern of preoperative rehabilitation better suits surgical lung cancer patients. Interactive Cardiovascular and Thoracic Surgery 2017;25:i11. [DOI: 10.1093/icvts/ivx280.037]
Lai 2019 {published data only (unpublished sought but not used)}
    1. Lai Y, Wang X, Zhou K, Su J, Che G. Impact of one-week preoperative physical training on clinical outcomes of surgical lung cancer patients with limited lung function: a randomized trial. Annals of Translational Medicine 2019;7(20):544. [DOI: 10.21037/atm.2019.09.151]
Licker 2016 {published data only}
    1. Bhatia C, Kayser B. Preoperative high-intensity interval training is effective and safe in deconditioned patients with lung cancer: a randomized clinical trial. Journal of Rehabilitation Medicine 2019;51(9):712-8. [DOI: 10.2340/16501977-2592]
    1. Karenovics W, Licker M, Christodoulou M, Diaper J, Bhatia C, Bridevaux P, et al. Does short-term preoperative exercise therapy influence long term lung functional outcome following lung cancer surgery? Interactive Cardiovascular and Thoracic Surgery 2016;23:i2. [DOI: 10.1093/icvts/ivw260.04]
    1. Karenovics W, Licker M, Ellenberger C, Christodoulou M, Diaper J, Bhatia C, et al. Short-term preoperative exercise therapy does not improve long-term outcome after lung cancer surgery: a randomized controlled study. European Journal of Cardio-thoracic Surgery 2017;52(1):47-54. [DOI: 10.1093/ejcts/ezx030]
    1. Licker M, Karenovics W, Diaper J, Fresard I, Triponez F, Ellenberger C, et al. Short-term preoperative high-intensity interval training in patients awaiting lung Cancer surgery: a randomized controlled trial. Journal of Thoracic Oncology 2016;12(2):323-33. [DOI: 10.1016/j.jtho.2016.09.125]
Liu 2020 {published data only}
    1. Liu Z, Qiu T, Pei L, Zhang Y, Xu L, Cui Y, et al. Two-week multimodal prehabilitation program improves perioperative functional capability in patients undergoing thoracoscopic lobectomy for lung cancer: a randomized controlled trial. Anesthesia and Analgesia 2020;131(3):840-9. [DOI: 10.1213/ANE.0000000000004342]
Morano 2013 {published data only}
    1. Morano MT, Araujo AS, Nascimento FB, da Silva GF, Mesquita R, Pinto JS, et al. Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: a pilot randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2013;94:53-8. [UTN Number: U1111-1122-2906]
    1. Morano MT, Mesquita R, da Silva GF, Araujo AS, Pinto JS, Neto AG, et al. Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial. BMC Pulmonary Medicine 2014;14:121.
    1. Pereira ED, Morano M, Araujo A, Nascimento F, Pinheiro G, Mesquita R, et al. Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: a pilot randomized clinical trial. American Journal of Respiratory and Critical Care Medicine 2013;187:A5119.
Pehlivan 2011 {published data only}
    1. Pehlivan E, Turna A, Gurses A, Gurses HN. The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial. Annals of Thoracic and Cardiovascular Surgery 2011;17:461-8.
Stefanelli 2013 {published data only}
    1. Stefanelli F, Meoli I, Cobuccio R, Curcio C, Amore D, Casazza D, et al. High-intensity training and cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and non-small-cell lung cancer undergoing lobectomy. European Journal of Cardio-thoracic Surgery 2013;44:e260-5.
References to studies excluded from this review Chen 2016 {published data only}
    1. Chen HM, Tsai CM, Wu YC, Lin KC, Lin CC. Effect of walking on circadian rhythms and sleep quality of patients with lung cancer: a randomised controlled trial. British Journal of Cancer 2016;115(11):1304-12.
Ferreira 2021 {published data only}
    1. Ferreira V, Minnella EM, Awasthi R, Gamsa A, Ferri L, Mulder D, et al. Multimodal prehabilitation for lung cancer surgery: a randomized controlled trial. Annals of Thoracic Surgery 2021;112(5):1600-8.
Garofano 2018 {published data only}
    1. Ellenberger C, Garofano N, Reynaud T, Triponez F, Diaper J, Bridevaux PO, et al. Patient and procedural features predicting early and mid-term outcome after radical surgery for non-small cell lung cancer. Journal of Thoracic Disease 2018;10(11):6020-9.
    1. Garofano N, Ellenberger C, Reynaud T, Triponez F, Diaper J, Bridevaux PO, et al. Patient and procedural features predicting early and mid-term outcome after radical surgery for non-small cell lung cancer. Swiss Medical Weekly 2018;148(5S):-.
Han 2016 {published data only}
    1. Han R, Lin HS. A clinical study on therapeutic effects of fitness Qigong Baduanjin on pulmonary function and quality of life of post-operative non-small cell lung cancer patients. Tianjin Journal of Traditional Chinese Medicine 2016;33(12):715-8.
Horváth 2017 {published data only}
    1. Horváth K, Bán B, Szántó Z, Ács P, Boncz I, Molics B. Physiotherapeutic methods aimed to improve the cardiorespiratory state before and after operation in patients with lung cancer. Value in Health 2017;20:A464.
Hsiao 2018 {published data only}
    1. Hsiao WL, Wang TJ. Testing efficacy of a pulmonary rehabilitation program for post lung cancer resection surgery. Supportive Care in Cancer 2018;26(2):S283.
Jonsson 2019 {published data only}
    1. Jonsson M, Hurtig-Wennlof A, Ahlsson A, Vidlund M, Cao Y, Westerdahl E. In-hospital physiotherapy and physical recovery 3 months after lung cancer surgery: a randomized controlled trial. Integrative Cancer Therapies 2019;18:1534735419876346.
    1. Jonsson M, Hurtig-Wennlof A, Ahlsson A, Vidlund M, Cao Y, Westerdahl E. In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial. Physiotherapy 2019;105(4):434-41.
Laurent 2020 {published data only}
    1. Laurent H, Aubreton S, Galvaing G, Pereira B, Merle P, Richard R, et al. Preoperative respiratory muscle endurance training improves ventilatory capacity and prevents pulmonary postoperative complications after lung surgery: a randomized controlled trial. European Journal of Physical and Rehabilitation Medicine 2020;56(1):73-81.
Meng 2018 {published data only}
    1. Meng SL, Yang F, Dai FQ, Chen S, Huang C, Tan Q, et al. Effect of a high intensive preoperative rehabilitation on the perioperative complications in patients with chronic obstructive pulmonary disease eligible for lung cancer surgery. Chinese Journal of Lung Cancer 2018;21(11):841-8.
Patel 2021 {published data only}
    1. Patel YS, Churchill IF, Sullivan KA Beauchamp M, Wald J, Mbuagbaw L, et al. OA04.01 Move for surgery – a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial. Journal of Thoracic Oncology 2021;10:S852-3.
Tenconi 2017 {published data only}
    1. Tenconi S, Galeone C, Fugazzaro S, Rapicetta C, Piro R, Formisano D. Perioperative and long-term effects of comprehensive pulmonary rehabilitation on exercise capacity, postoperative outcome and quality of life in patients undergoing lung resection: a randomized controlled trial granted by the ministry of health. Interactive Cardiovascular and Thoracic Surgery 2017;25:i25.
Vagvolgyi 2017 {published data only}
    1. Vagvolgyi A, Rozgonyi Z, Kerti M, Vadasz P, Varga J. Effectiveness of perioperative pulmonary rehabilitation in thoracic surgery. Journal of Thoracic Disease 2017;9(6):1584-91.
Zhou 2017 {published data only}
    1. Zhou K, Su J, Lai Y, Li P, Li S, Che G. Short-term inpatient-based high-intensive pulmonary rehabilitation for lung cancer patients: is it feasible and effective? Journal of Thoracic Disease 2017;9(11):4486-93.
Additional references Agostini 2010
    1. Agostini P, Cieslik H, Rathinam S, Bishay E, Kalkat M, Rajesh P, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax 2010;65:815-8.
AIHW 2019
    1. Australian Institute of Health and Welfare. Cancer in Australia 2019. Cancer series no.119. Cat. no. CAN 123. Canberra: AIHW. (accessed 25 August 2021).
Altman 1996
    1. Altman DG, Bland JM. Statistics notes: detecting skewness from summary information. BMJ 1996;313(7066):1200.
Armstrong 1984
    1. Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Medicine and Science in Sports and Exercise 1984;16(6):529-38.
Atkins 2004
    1. Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S, et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches the GRADE Working Group. BMC Health Services Research 2004;4(1):38.
Benzo 2007
    1. Benzo R, Kelley G, Recchi L, Hofman A, Sciurba F. Complications of lung resection and exercise capacity: a meta-analysis. Respiratory Medicine 2007;101(8):1790-7.
Billé 2021
    1. Billé A, Buxton J, Viviano A, Gammon D, Veres L, Routledge T, et al. Preoperative physical activity predicts surgical outcomes following lung cancer resection. Integrative Cancer Therapies 2021;20:1534735420975853.
Brunelli 2009
    1. Brunelli A, Belardinelli R, Refai M, Salati M, Socci L, Pompili C, et al. Peak oxygen consumption during cardiopulmonary exercise test improves risk stratification in candidates to major lung resection. Chest 2009;135(5):1260-7.
Brunelli 2013
    1. Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013;143(5):e166S-90S.
Caspersen 1985
    1. Caspersen C. Physical activity, exercise and physical fitness: definitions and distinctions for health related research. Public Health Reports 1985;100(2):126-31.
Cavalheri 2013
    1. Cavalheri V, Jenkin S, Hill K. Physiotherapy practice patterns for patients undergoing surgery for lung cancer: a survey of hospitals in Australia and New Zealand. Internal Medicine Journal 2013;43(4):394-401.
Cavalheri 2015
    1. Cavalheri V, Jenkins S, Cecins N, Gain K, Phillips M, Sanders LH, et al. Impairments after curative intent treatment for non-small cell lung cancer: a comparison with age and gender-matched healthy controls. Respiratory Medicine 2015;109(10):1332-9.
Cavalheri 2020
    1. Cavalheri V, Granger CL. Exercise training as part of lung cancer therapy. Respirology 2020;25(S2):80-7.
Cavelheri 2019
    1. Cavalheri V, Burtin C, Formico VR, Nonoyama ML, Jenkins S, Spruit MA, et al. Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer. Cochrane Database of Systematic Reviews 2019, Issue 6. Art. No: CD009955. [DOI: 10.1002/14651858.CD009955.pub3]
Cooley 2000
    1. Cooley ME. Symptoms in adults with lung cancer. A systematic research review. Journal of Pain and Symptom Management 2000;19(2):137-53.
Coups 2009
    1. Coups E, Park B, Feinstein M, Steingart R, Egleston B, Wilson D, et al. Physical activity among lung cancer survivors: changes across the cancer trajectory and associations with quality of life. Cancer Epidemiology, Biomarkers & Prevention 2009;18(2):664-72.
Covidence [Computer program]
    1. Covidence. Version accessed 25 November 2021. Melbourne, Australia: Veritas Health Innovation. Available at .
Dela Cruz 2011
    1. Dela Cruz C, Tanoue L, Matthay R. Lung cancer: epidemiology, etiology, and prevention. Clinics in Chest Medicine 2011;32(4):605-44.
DerSimonian 1986
    1. DerSimonian R, Laird N. Meta-analysis in clinical trials. Controlled Clinical Trials 1986;7(3):177-88.
Evans 2019
    1. Evans JM, Ray A, Dale M, Morgan H, Dimmock P, Carolan-Rees G. Thopaz+ Portable Digital System for managing chest drains: a NICE medical technology Guidance. Applied Health Economics and Health Policy 2019;17(3):285-94.
Ferlay 2021
    1. Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, Znaor A, et al. Cancer statistics for the year 2020: an overview. International Journal of Cancer 2021;149(4):778-89.
Granger 2014
    1. Granger C, McDonald C, Irving L, Clark R, Gough K, Murnane A, et al. Low physical activity levels and functional decline in individuals with lung cancer. Lung Cancer 2014;83(2):292-9.
Granger 2015
    1. Granger CL, Holland AE, Gordon IR, Denehy L. Minimal important difference of the 6-minute walk distance in lung cancer. Chronic Respiratory Disease 2015;12(2):146-54.
Gravier 2022
    1. Gravier F-E, Smondack P, Prieur G, Medrinal C, Combret Y, Muir J-F, et al. Effects of exercise training in people with non-small cell lung cancer before lung resection: a systematic review and meta-analysis. Thorax 2022;77(5):486-496(5):486-96.
Guyatt 2008
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924-6.
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
Higgins 2021
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Available from .
Hung 2011
    1. Hung R, Krebs P, Coups E, Feinstein M, Park B, Burkhalter J, et al. Fatigue and functional impairment in early-stage non-small cell lung cancer survivors. Journal of Pain and Symptom Management 2011;41(2):426-35.
Institute of Medicine 2015
    1. Institute of Medicine (IOM). Transforming Health Care Scheduling and Access: Getting to Now. Washington (DC): The National Academies Press, 2015.
Jones 2009
    1. Jones L, Eves N, Haykowsky M, Freedland S, Mackey J. Exercise intolerance in cancer and the role of exercise therapy to reverse dysfunction. Lancet Oncology 2009;10(6):598-605.
Li 2019
    1. Li X, Li S, Yan S, Wang Y, Wang X, Sihoe AD, et al. Impact of preoperative exercise therapy on surgical outcomes in lung cancer patients with or without COPD: a systematic review and meta-analysis. Cancer Management and Research 2019;11:1765-77.
Loewen 2007
    1. Loewen GM, Watson D, Kohman L, Herndon JE, Shennib H, Kernstine K, et al. Preoperative exercise VO2 measurement for lung resection candidates: results of Cancer and Leukemia Group B Protocol 9238. Journal of Thoracic Oncology 2007;2(7):619-25.
Lugg 2016
    1. Lugg ST, Agostini PJ, Tikka T, Kerr A, Adams K, Bishay E, et al. Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax 2016;71(2):171-6.
McCarthy 2015
    1. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No: CD003793. [DOI: 10.1002/14651858.CD003793.pub3]
McKenna 2006
    1. McKenna R, Houck W, Fuller C. Video-assisted thoracic surgery lobectomy: experience with 1100 cases. Annals of Thoracic Surgery 2006;81(2):421-5.
McTiernan 2008
    1. McTiernan A. Mechanisms linking physical activity with cancer. Nature Reviews. Cancer 2008;8(3):205-11.
NCCN 2021
    1. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): non-small cell lung cancer. 2021. (accessed 25 August 2021).
Novoa 2009
    1. Novoa N, Varela G, Jimenez M, Aranda J. Influence of major pulmonary resection on postoperative daily ambulatory activity of the patients. Interactive Cardiovascular and Thoracic Surgery 2009;9(6):934-8.
Pan 2012
    1. Pan HH, Lin KC, Ho ST, Liang CY, Lee SC, Wang KY. Factors related to daily life interference in lung cancer patients: a cross-sectional regression tree study. European Journal of Oncology Nursing 2012;16(4):345-52.
Pompili 2011
    1. Pompili C, Brunelli A, Salati M, Refai M, Sabbatini A. Impact of the learning curve in the use of a novel electronic chest drainage system after pulmonary lobectomy: a case-matched analysis on the duration of chest tube usage. Interactive Cardiovascular and Thoracic Surgery 2011;13(5):490-3.
Pouwels 2015
    1. Pouwels S, Fiddelaers J, Teijink JA, Woorst JF, Siebenga J, Smeenk FW. Preoperative exercise therapy in lung surgery patients: a systematic review. Respiratory Medicine 2015;109(12):1495-504.
Reeve 2010
    1. Reeve JC, Nicol K, Stiller K, McPherson KM, Birch P, Gordon IR, et al. Does physiotherapy reduce the incidence of postoperative pulmonary complications following pulmonary resection via open thoracotomy? A preliminary randomised single-blind clinical trial. European Journal of Cardio-thoracic Surgery 2010;37(5):1158-66.
Review Manager Web 2022 [Computer program]
    1. Review Manager Web (RevMan Web). Version 4.12.0. The Cochrane Collaboration, 2022. Available at .
Rodriguez‐Larrad 2014
    1. Rodriguez-Larrad A, Lascurain-Aguirrebena I, Abecia-Inchaurregui L, Seco J. Perioperative physiotherapy in patients undergoing lung cancer resection. Interactive Cardiovascular and Thoracic Surgery 2014;19:269-81.
Rosen 2016
    1. Rosen JE, Keshava HB, Yao X, Kim AW, Detterbeck FC, Boffa DJ. The natural history of operable non-small cell lung cancer in the National Cancer Database. Annals of Thoracic Surgery 2016;101(5):1850-5.
Rosero 2019
    1. Rosero ID, Ramírez-Vélez R, Lucia A, Martínez-Velilla N, Santos-Lozano A, Valenzuela PL, et al. Systematic review and meta-analysis of randomized, controlled trials on preoperative physical exercise interventions in patients with non-small-cell lung cancer. Cancers 2019;11(7):944.
Schmitz 2010
    1. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Medicine and Science in Sports and Exercise 2010;42(7):1409-26.
Sebio Garcia 2016
    1. Sebio Garcia R, Yanez Brage MI, Gimenez Moolhuyzen E, Granger CL, Denehy L. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interactive Cardiovascular and Thoracic Surgery 2016;23:486-97.
SEER 2018
    1. National Cancer Institute Surveillance, Epidemiology, and End Results program. Cancer stat facts: lung and bronchus cancer. (accessed 25 August 2021).
Siegel 2019
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: a Cancer Journal for Clinicians 2019;69(1):7-34.
Spruit 2013
    1. Spruit MA, Singh SJ, Garvey C, Zu Wallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine 2013;188(8):e13-64.
Tanaka 2002
    1. Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y. Impact of dyspnea, pain, and fatigue on daily life activities in ambulatory patients with advanced lung cancer. Journal of Pain and Symptom Management 2002;23(5):417-23.
The NHS Cancer Plan 2000
    1. Department of Health. The NHS cancer plan: a plan for investment, a plan for reform. (accessed prior to 12 September 2022).
Voorn 2021
    1. Voorn M, Franssen R, Verlinden J, Bootsma G, Ruysscher D, Bongers B, et al. Associations between pretreatment physical performance tests and treatment complications in patients with non-small cell lung cancer: a systematic review. Critical Reviews in Oncology/Hematology 2021;158:103207.
Wan 2014
    1. Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Medical Research Methodology 2014;14(1):135.
Xu 2022
    1. Xu X, Cheung D, Smith R, Lai A, Lin C. The effectiveness of pre- and post-operative rehabilitation for lung cancer: a systematic review and meta-analysis on postoperative pulmonary complications and length of hospital stay. Clinical Rehabilitation 2022;36(2):172-89.
References to other published versions of this review Cavalheri 2015b
    1. Cavalheri V, Granger C. Preoperative exercise training for patients with non-small cell lung cancer. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No: CD012020. [DOI: 10.1002/14651858.CD012020]
Cavalheri 2017
    1. Cavalheri V, Granger C. Preoperative exercise training for patients with non-small cell lung cancer. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No: CD012020. [DOI: 10.1002/14651858.CD012020.pub2]

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner