Cardiopulmonary exercise testing for the prediction of morbidity risk after rectal cancer surgery. Issue 9 (11th June 2014)

• Record Type: Journal Article
• Authors: West, M A; Parry, M G; Lythgoe, D; Barben, C P; Kemp, G J; Grocott, M P W; Jack, S
• Is Part Of: British journal of surgery. Volume 101:Issue 9(2014:Sep.)
• Page Start: 1166
• Page End: 1172
• Publication Date: 2014-06-11
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.9551
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: This study investigated the relationship between objectively measured physical fitness variables derived by cardiopulmonary exercise testing (CPET) and in-hospital morbidity after rectal cancer surgery. Methods: Patients scheduled for rectal cancer surgery underwent preoperative CPET (reported blind to patient characteristics) with recording of morbidity (recorded blind to CPET variables). Non-parametric receiver operating characteristic (ROC) curves and logistic regression were used to assess the relationship between CPET variables and postoperative morbidity. Results: Of 105 patients assessed, 95 (72 men) were included; ten patients had no surgery and were excluded (3 by choice, 7 owing to unresectable metastasis). Sixty-eight patients had received neoadjuvant treatment. ROC curve analysis of oxygen uptake (V ˙ o 2 ) at estimated lactate threshold (θ ^ L ) and peak V ˙ o 2 gave an area under the ROC curve of 0·87 (95 per cent confidence interval 0·78 to 0·95; P < 0·001) and 0·85 (0·77 to 0·93; P < 0·001) respectively, indicating that they can help discriminate patients at risk of postoperative morbidity. The optimal cut-off points identified were 10·6 and 18·6 ml per kg per min for V ˙ o 2 at θ ^ L and peak respectively. Conclusion: CPET can help predict morbidity after rectal cancer surgery. Abstract : Practical, useful and worthwhile