Linda O'Neill1, Sophie Reynolds2, Gráinne Sheill3, Emer Guinan2, David Mockler4, Justin Geoghegan5, Kevin Conlon5,6,7, John V Reynolds7,8, Juliette Hussey3. 1. Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland. oneilll8@tcd.ie. 2. School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland. 3. Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland. 4. John Stearne Library, Trinity Centre for Health Sciences, Dublin, Ireland. 5. Department of Surgery, St Vincent's University Hospital, Dublin, Ireland. 6. Department of Surgery, Tallaght University Hospital, Dublin, Ireland. 7. Department of Surgery, Trinity College Dublin, the University of Dublin, Dublin, Ireland. 8. Department of Surgery, St James's Hospital, Dublin, Ireland.
Abstract
PURPOSE: Surgery is the only potentially curative treatment for pancreatic and liver cancer. However, even in high-volume centres, surgical resection is associated with significant morbidity with resultant physical decline. This systematic review explored physical function and its' implications in the management of resectable cancer of the pancreas and liver. METHODS: EMBASE, Medline OVID, CINAHL, Cochrane Library and Web of Science were searched up to June 2019 using a predefined search strategy. Screening of titles, abstracts, and full texts, data extraction, and risk of bias assessment was performed independently by two reviewers. A third reviewer resolved disagreements by consensus. RESULTS: Sixteen studies with a total of 1224 participants were included. Heterogeneity of the literature prevented a meta-analysis. Physical function across the pancreatic/liver cancer trajectory has been under investigated. The relationship between physical function and pancreatic/liver cancer resection outcome remains unclear, although anaerobic threshold appears the strongest predictor of postoperative outcomes. Conclusions regarding the impact of rehabilitative interventions on physical function were limited due to risk of bias concerns. CONCLUSIONS: High-quality evidence regarding the implications of physical function in resectable pancreatic and liver cancers is lacking. Well-designed trials are required to examine physical function across the pancreatic/liver cancer continuum and to measure the impact of rehabilitation on physical function. IMPLICATIONS FOR CANCER SURVIVORS: As survival rates for pancreatic and liver cancer slowly improve a greater understanding of the impact of these cancers and their treatments on physical function, and the potential impact of rehabilitative interventions for survivors is required.
PURPOSE: Surgery is the only potentially curative treatment for pancreatic and liver cancer. However, even in high-volume centres, surgical resection is associated with significant morbidity with resultant physical decline. This systematic review explored physical function and its' implications in the management of resectable cancer of the pancreas and liver. METHODS: EMBASE, Medline OVID, CINAHL, Cochrane Library and Web of Science were searched up to June 2019 using a predefined search strategy. Screening of titles, abstracts, and full texts, data extraction, and risk of bias assessment was performed independently by two reviewers. A third reviewer resolved disagreements by consensus. RESULTS: Sixteen studies with a total of 1224 participants were included. Heterogeneity of the literature prevented a meta-analysis. Physical function across the pancreatic/liver cancer trajectory has been under investigated. The relationship between physical function and pancreatic/liver cancer resection outcome remains unclear, although anaerobic threshold appears the strongest predictor of postoperative outcomes. Conclusions regarding the impact of rehabilitative interventions on physical function were limited due to risk of bias concerns. CONCLUSIONS: High-quality evidence regarding the implications of physical function in resectable pancreatic and liver cancers is lacking. Well-designed trials are required to examine physical function across the pancreatic/liver cancer continuum and to measure the impact of rehabilitation on physical function. IMPLICATIONS FOR CANCER SURVIVORS: As survival rates for pancreatic and liver cancer slowly improve a greater understanding of the impact of these cancers and their treatments on physical function, and the potential impact of rehabilitative interventions for survivors is required.
Authors: Hao Luo; Daniel A Galvão; Robert U Newton; Pedro Lopez; Colin Tang; Ciaran M Fairman; Nigel Spry; Dennis R Taaffe Journal: Pancreas Date: 2021-03-01 Impact factor: 3.243