Jessica M Scott1, Whitney E Hornsby, Amy Lane, Aarti A Kenjale, Neil D Eves, Lee W Jones. 1. 1Universities Space Research Association, Houston, TX; 2Duke University Medical Center, Durham, NC; 3Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, CANADA; and 4Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Abstract
PURPOSE: To accurately assess exercise interventions and to evaluate acute and chronic cardiovascular effects in patients with early-stage cancer, consistently reliable functional outcome measures must be obtained. An incremental cardiopulmonary exercise test (CPET) with gas exchange measurement to assess peak oxygen consumption (V˙O2peak) provides the gold standard outcome of cardiorespiratory fitness. METHODS: In the context of a randomized controlled trial, 40 patients with prostate cancer (mean age, 59 ± 7 yr) after radical prostatectomy performed two maximal CPET within 5.6 ± 5.5 d of each other. Incremental treadmill tests were performed in the morning under identical laboratory conditions. Reliability and within-subject variability from test 1 to test 2 for peak and submaximal variables were assessed by correlation coefficients, intraclass correlations (ICC), Bland-Altman plots, coefficient of variation, and paired t-tests. RESULTS: There was high reliability between CPET for V˙O2peak (r = 0.92; P < 0.001; ICC, 0.900), ventilatory threshold (r = 0.88; P < 0.001; ICC, 0.927), minute ventilation-carbon dioxide production relation (V˙E/V˙CO2) (r = 0.86; P < 0.001; ICC, 0.850), and peak heart rate (r = 0.95; P < 0.001; ICC, 0.944). However, high within-subject variability was observed for all CPET parameters (mean coefficient of variation, 4.7%). Compared with those for test 1, significantly higher mean values were observed for V˙O2peak (27.0 ± 5.6 vs 28.1 ± 5.3 mL·kg·min, P < 0.05), ventilatory threshold (1.91 ± 0.5 vs 1.97 ± 0.4 L·min, P < 0.05), and V˙E/V˙CO2 (31.3 ± 5.8 vs 32.8 ± 3.4, P < 0.05) in test 2. CONCLUSIONS: These findings indicate the presence of significant, and potentially clinically important, variability in CPET procedures in men with clinically localized prostate cancer and have important implications for the application and use of CPET to evaluate the efficacy of interventions to improve aerobic capacity in the oncology setting.
RCT Entities:
PURPOSE: To accurately assess exercise interventions and to evaluate acute and chronic cardiovascular effects in patients with early-stage cancer, consistently reliable functional outcome measures must be obtained. An incremental cardiopulmonary exercise test (CPET) with gas exchange measurement to assess peak oxygen consumption (V˙O2peak) provides the gold standard outcome of cardiorespiratory fitness. METHODS: In the context of a randomized controlled trial, 40 patients with prostate cancer (mean age, 59 ± 7 yr) after radical prostatectomy performed two maximal CPET within 5.6 ± 5.5 d of each other. Incremental treadmill tests were performed in the morning under identical laboratory conditions. Reliability and within-subject variability from test 1 to test 2 for peak and submaximal variables were assessed by correlation coefficients, intraclass correlations (ICC), Bland-Altman plots, coefficient of variation, and paired t-tests. RESULTS: There was high reliability between CPET for V˙O2peak (r = 0.92; P < 0.001; ICC, 0.900), ventilatory threshold (r = 0.88; P < 0.001; ICC, 0.927), minute ventilation-carbon dioxide production relation (V˙E/V˙CO2) (r = 0.86; P < 0.001; ICC, 0.850), and peak heart rate (r = 0.95; P < 0.001; ICC, 0.944). However, high within-subject variability was observed for all CPET parameters (mean coefficient of variation, 4.7%). Compared with those for test 1, significantly higher mean values were observed for V˙O2peak (27.0 ± 5.6 vs 28.1 ± 5.3 mL·kg·min, P < 0.05), ventilatory threshold (1.91 ± 0.5 vs 1.97 ± 0.4 L·min, P < 0.05), and V˙E/V˙CO2 (31.3 ± 5.8 vs 32.8 ± 3.4, P < 0.05) in test 2. CONCLUSIONS: These findings indicate the presence of significant, and potentially clinically important, variability in CPET procedures in men with clinically localized prostate cancer and have important implications for the application and use of CPET to evaluate the efficacy of interventions to improve aerobic capacity in the oncology setting.
Authors: Lee W Jones; Neil D Eves; John R Mackey; Carolyn J Peddle; Mark Haykowsky; Anil A Joy; Kerry S Courneya; Keith Tankel; Jennifer Spratlin; Tony Reiman Journal: Lung Cancer Date: 2006-11-17 Impact factor: 5.705
Authors: Sharon Ann Hunt; William T Abraham; Marshall H Chin; Arthur M Feldman; Gary S Francis; Theodore G Ganiats; Mariell Jessup; Marvin A Konstam; Donna M Mancini; Keith Michl; John A Oates; Peter S Rahko; Marc A Silver; Lynne Warner Stevenson; Clyde W Yancy Journal: J Am Coll Cardiol Date: 2009-04-14 Impact factor: 24.094
Authors: Leslie I Katzel; John D Sorkin; Richard F Macko; Barbara Smith; Frederick M Ivey; Lisa M Shulman Journal: Med Sci Sports Exerc Date: 2011-12 Impact factor: 5.411
Authors: Megan N Hawkins; Peter B Raven; Peter G Snell; James Stray-Gundersen; Benjamin D Levine Journal: Med Sci Sports Exerc Date: 2007-01 Impact factor: 5.411
Authors: Lee W Jones; Whitney E Hornsby; Stephen J Freedland; Amy Lane; Miranda J West; Judd W Moul; Michael N Ferrandino; Jason D Allen; Aarti A Kenjale; Samantha M Thomas; James E Herndon; Bridget F Koontz; June M Chan; Michel G Khouri; Pamela S Douglas; Neil D Eves Journal: Eur Urol Date: 2013-11-22 Impact factor: 20.096
Authors: Jessica M Scott; Emily C Zabor; Emily Schwitzer; Graeme J Koelwyn; Scott C Adams; Tormod S Nilsen; Chaya S Moskowitz; Konstantina Matsoukas; Neil M Iyengar; Chau T Dang; Lee W Jones Journal: J Clin Oncol Date: 2018-06-12 Impact factor: 44.544
Authors: Agnieszka Lemanska; Karen Poole; Jonathan J Aning; Bruce A Griffin; Ralph Manders; John M Saxton; Joe Wainwright; Sara Faithfull Journal: Eur Rev Aging Phys Act Date: 2019-01-10 Impact factor: 3.878
Authors: Eva M Zopf; Holger Schulz; Jonas Poeschko; Kerstin Aschenbroich; Thomas Wilhelm; Ernst Eypasch; Elmar Kleimann; Kai Severin; Jutta Benz; Enwu Liu; Wilhelm Bloch; Freerk T Baumann Journal: Support Care Cancer Date: 2021-10-08 Impact factor: 3.603
Authors: Jessica M Scott; Samantha M Thomas; James E Herndon; Pamela S Douglas; Anthony F Yu; Valerie Rusch; James Huang; Catherine Capaci; Jenna N Harrison; Kurtis J Stoeckel; Tormod Nilsen; Elisabeth Edvardsen; Meghan G Michalski; Neil D Eves; Lee W Jones Journal: J Cachexia Sarcopenia Muscle Date: 2021-10-17 Impact factor: 12.910
Authors: Andrew D Frugé; John A Dasher; David Bryan; Soroush Rais-Bahrami; Wendy Demark-Wahnefried; Gary R Hunter Journal: Int J Cancer Clin Res Date: 2017-10-16
Authors: J E M Blackwell; B Doleman; C L Boereboom; A Morton; S Williams; P Atherton; K Smith; J P Williams; B E Phillips; J N Lund Journal: Prostate Cancer Prostatic Dis Date: 2020-03-10 Impact factor: 5.554