Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial

Banerjee, Srijit and Manley, Kate and Shaw, Barnabas and Lewis, Liane and Cucato, Gabriel and Mills, Robert and Rochester, Mark and Clark, Allan and Saxton, John M. (2017) Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial. Supportive Care in Cancer. ISSN 1433-7339

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    Abstract

    Purpose Strategies to improve pre-operative cardiopulmonary fitness could positively impact recovery after surgery. Thisstudy investigated the feasibility of vigorous intensity aerobic interval exercise in bladder cancer patients prior to radicalcystectomy (RC).Methods A total of 60 patients were randomised (1:1) to exercise or control following a cardiopulmonary exercise test (CPET).The exercise group was offered twice-weekly pre-operative supervised vigorous intensity aerobic interval exercise in addition tostandard treatment. The controls received standard treatment only. A repeat CPET was undertaken before surgery and postoperative recovery outcomes were recorded.Results Over half of the 112 eligible patients approached in the clinic were recruited to the study (53.5%), with recruited patientsattending a median of 8 (range 1–10) exercise sessions over a pre-operative period of 3–6 weeks. Improvements in peak values ofoxygen pulse (P = 0.001), minute ventilation (P = 0.002) and power output (P < 0.001) were observed at the follow-up CPET inthe exercise group versus controls and there were no adverse events. Although this feasibility study was not powered to detectchanges in post-operative recovery outcomes, there were marginal (non-significant) differences in favour of the exercise group inpost-operative Clavien-Dindo score and need for high dependency unit inotropic support.Conclusions Bladder cancer patients respond well to pre-surgical aerobic interval exercise, and the improvements in cardiopulmonary fitness variables could have important implications for post-operative recuperation after RC. These findings provide astrong foundation for an adequately powered randomised controlled trial.