Multidisciplinary Rehabilitation Following Upper Gastrointestinal Cancer Surgery (RESTORE II)

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Objective: RESTORE II compared in an RCT the impact of a 12-week multidisciplinary rehabilitation program versus standard care (SC) on cardiorespiratory fitness and physical function in patients postupper gastrointestinal (UGI) oncologic surgery. Summary of Background Data: The value of multidisciplinary cancer rehabilitation in UGI cancer survivorship is unclear, with limited high-quality data. Methods: Disease-free patients, ≥3 months post-UGI cancer resection were randomized to SC or RESTORE (physiotherapy-led aerobic and resistance exercise, dietary counselling, and psychosocial support). The primary endpoint was cardiorespiratory fitness (VO 2 peak). Secondary endpoints included body composition (anthropometry and bioimpedance analysis), muscle strength (hand grip strength and leg-press 1-repetition maximum), functional performance (Short Physical Performance Battery), physical activity (accelerometery), and health-related quality of life (EORTC-QLQ-C30). Assessments were conducted at baseline (T0), postintervention (T1), and 3-month follow-up (T2). Results: Eighty-eight participants were randomized to SC (n=44) or RESTORE (n=44). Median age was 67.5 (range: 43–86) years, n=60 (68.2%) male, and median time postsurgery was 33 (range: 3.5–145) months. VO₂peak remained stable in the SC group. Estimated interaction effects for time × group indicate that the mean increases in VO₂peak were greater for RESTORE relative to SC from baseline to T1, by a mean of 1.5 mL/min/kg (95% CI: 0.52–2.48; P -value=0.003), and from baseline to T2 by a mean of 1.23 mL/min/kg (95% CI: 0.18–2.27; P -value=0.02). Secondary endpoints remained stable across treatment arms with no significant differences observed. Conclusion: RESTORE II provides Level I evidence that cardiorespiratory fitness can be targeted and improved in survivors of UGI cancer surgery.