Perioperative medicine & outcomes
Cardiopulmonary exercise variables and their association with postoperative morbidity and mortality after major oesophagogastric cancer surgery—a multicentre observational study
Authors' conclusion
VO2 peak was not associated with 1-yr survival after oesophagogastric cancer resection. Tumour characteristics and major complications were associated with survival; however, only some selected pre-neoadjuvant treatment CPET variables were associated with 3-yr survival.
Study context
- Population
- Patients undergoing oesophagogastric cancer resection and cardiopulmonary exercise testing (CPET) (pre- or post-neoadjuvant treatment, or both), 7 UK centres
- Participants
- 611 patients · 7 UK centres
- Exposure
- Preoperative CPET variables vs postoperative outcomes
- Outcome
- Association of VO2 peak with postoperative survival
- Follow-up
- 1 yr
Methodological detailsobservational
- Observational
Main finding
As reported in the abstract
VO2 peak and 1-yr survival
- No association between VO2 peak or other selected CPET variables and 1-yr survival in the overall cohort
Observational data: associations, not effects.
Further findings
Postoperative outcomes, overall cohort
- Oesophagectomy
- 475 (78%)
- Major complications
- 25%
- 1-yr mortality
- 18%
- 3-yr mortality
- 43%
Anaerobic threshold relative to ideal body weight and 3-yr survival, overall cohort
- Associated with 3-yr survival
- P = 0.013
Tumour characteristics and Clavien-Dindo ≥3a and 1-yr and 3-yr survival
- Tumour characteristics (ypT/ypN/tumour regression/lymphovascular invasion/resection margin) associated with survival
- P < 0.001
- Clavien-Dindo ≥3a associated with survival
- P < 0.001
Pre-neoadjuvant treatment CPET variables and 3-yr survival (subgroup)
- Anaerobic threshold, absolute
- P = 0.024
- Anaerobic threshold relative to ideal body weight
- P = 0.001
- Anaerobic threshold relative to body surface area
- P = 0.009
- VE/VCO2 at anaerobic threshold
- P = 0.026
- No other CPET variables (pre- or post-neoadjuvant treatment) associated with survival
Original publication
Cardiopulmonary exercise variables and their association with postoperative morbidity and mortality after major oesophagogastric cancer surgery—a multicentre observational study. BJA Open. Published 7 June 2024. doi:10.
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