Dorothea Clauss1, Christine Tjaden2, Thilo Hackert2, Lutz Schneider2, Cornelia M Ulrich3,4, Joachim Wiskemann5, Karen Steindorf6. 1. Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases and German Cancer Research Center, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. 2. Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. 3. Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. 4. Department of Population Health Sciences, Huntsman Cancer Institute and University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA. 5. Division of Medical Oncology, National Center for Tumor Diseases and Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. 6. Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases and German Cancer Research Center, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. k.steindorf@dkfz.de.
Abstract
PURPOSE: Cancer patients frequently experience reduced physical fitness due to the disease itself as well as treatment-related side effects. However, studies on physical fitness in pancreatic cancer patients are missing. Therefore, we assessed cardiorespiratory fitness and muscle strength of pancreatic cancer patients. METHODS: We included 65 pancreatic cancer patients, mostly after surgical resection. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing (CPET) and 6-min walk test (6MWT). Hand-held dynamometry was used to evaluate isometric muscle strength. Physical fitness values were compared to reference values of a healthy population. Associations between sociodemographic and clinical variables with patients' physical fitness were analyzed using multiple regression models. RESULTS: Cardiorespiratory fitness (VO2peak, 20.5 ± 6.9 ml/min/kg) was significantly lower (-24%) compared to healthy reference values. In the 6MWT pancreatic cancer patients nearly reached predicted values (555 vs. 562 m). Maximal voluntary isometric contraction (MVIC) of the upper (-4.3%) and lower extremities (-13.8%) were significantly lower compared to reference values. Overall differences were larger in men than those in women. Participating in regular exercise in the year before diagnosis was associated with greater VO2peak (p < .05) and MVIC of the knee extensors (p < .05). CONCLUSIONS: Pancreatic cancer patients had significantly impaired physical fitness with regard to both cardiorespiratory function and isometric muscle strength, already in the early treatment phase (median 95 days after surgical resection). Our findings underline the need to investigate exercise training in pancreatic cancer patients to counteract the loss of physical fitness.
PURPOSE:Cancerpatients frequently experience reduced physical fitness due to the disease itself as well as treatment-related side effects. However, studies on physical fitness in pancreatic cancerpatients are missing. Therefore, we assessed cardiorespiratory fitness and muscle strength of pancreatic cancerpatients. METHODS: We included 65 pancreatic cancerpatients, mostly after surgical resection. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing (CPET) and 6-min walk test (6MWT). Hand-held dynamometry was used to evaluate isometric muscle strength. Physical fitness values were compared to reference values of a healthy population. Associations between sociodemographic and clinical variables with patients' physical fitness were analyzed using multiple regression models. RESULTS:Cardiorespiratory fitness (VO2peak, 20.5 ± 6.9 ml/min/kg) was significantly lower (-24%) compared to healthy reference values. In the 6MWT pancreatic cancerpatients nearly reached predicted values (555 vs. 562 m). Maximal voluntary isometric contraction (MVIC) of the upper (-4.3%) and lower extremities (-13.8%) were significantly lower compared to reference values. Overall differences were larger in men than those in women. Participating in regular exercise in the year before diagnosis was associated with greater VO2peak (p < .05) and MVIC of the knee extensors (p < .05). CONCLUSIONS:Pancreatic cancerpatients had significantly impaired physical fitness with regard to both cardiorespiratory function and isometric muscle strength, already in the early treatment phase (median 95 days after surgical resection). Our findings underline the need to investigate exercise training in pancreatic cancerpatients to counteract the loss of physical fitness.
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