Evidence map›Paper›PMID 39237725›Full record

Trial reportCanadian journal of anaesthesia = Journal canadien d'anesthesie2024

Home-based exercise prehabilitation to improve disease-free survival and return to intended oncologic treatment after cancer surgery in older adults with frailty: a secondary analysis of a randomized trial.

Daniel I McIsaac, Nathaniel Neilipovitz, Gregory L Bryson, Sylvain Gagne, Allen Huang, Manoj Lalu, Luke T Lavallée, Husein Moloo, Barbara Power, Celena Scheede-Bergdahl and 4 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02934230 (The Prehabilitation Study), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02934230 naunknown statusnot on this map

The Prehabilitation Study: Exercise Before Surgery to Improve Patient Function in People

TypeinterventionalSponsorOttawa Hospital Research InstituteRan2017 to 2021Enrolled204ConditionsCancer, FrailtyArmsPrehabilitation Program
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Daniel I McIsaacDepartment of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada. dmcisaac@toh.ca.ORCID 0000-0002-8543-1859
Nathaniel NeilipovitzClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Gregory L BrysonDepartment of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.
Sylvain GagneDepartment of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.
Allen HuangClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Manoj LaluDepartment of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.
Luke T LavalléeClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Husein MolooClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Barbara PowerClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Celena Scheede-BergdahlDepartment of Kinesiology and Physical Education, Faculty of Education, McGill University, Montreal, QC, Canada.
Carl van WalravenClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Colin J L McCartneyDepartment of Anesthesiology and Pain Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Monica TaljaardClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Emily HladkowiczClinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Funding

Canadian Frailty Network Catalyst 2018International Anesthesia Research Society IMRA 2016
6 · The paper itself

Abstract

backgroundImproving survivorship for patients with cancer and frailty is a priority. We aimed to estimate whether exercise prehabilitation improves disease-free survival and return to intended oncologic treatment for older adults with frailty undergoing cancer surgery.

methodsWe conducted a secondary analysis of the oncologic outcomes of a randomized trial of patients ≥ 60 yr of age with frailty undergoing elective cancer surgery. Participants were randomized either to a supported, home-based exercise program plus nutritional guidance or to usual care. Outcomes for this analysis were one-year disease-free survival and return to intended oncologic treatment. We estimated complier average causal effects to account for intervention adherence.

resultsWe randomized 204 participants (102 per arm); 182 were included in our modified intention-to-treat population and, of these participants, 171/182 (94%) had complete one-year follow up. In the prehabilitation group, 18/94 (11%) died or experienced cancer recurrence, compared with 19/88 (11%) in the control group (hazard ratio [HR], 1.25; 95% confidence interval [CI], 0.66 to 2.34; P = 0.49). Return to intended oncologic treatment occurred in 24/94 (29%) patients the prehabilitation group vs 20/88 (23%) in the usual care group (HR, 1.53; 95% CI, 0.84 to 2.77; P = 0.16). Complier average causal effects directionally diverged for disease-free survival (HR, 0.91; 95% CI, 0.20 to 4.08; P = 0.90) and increased the point estimate for return to treatment (HR, 2.04; 95% CI, 0.52 to 7.97; P = 0.30), but in both cases the CIs included 1.

conclusionsRandomization to home-based exercise prehabilitation did not lead to significantly better disease-free survival or earlier return to intended oncologic treatment in older adults with frailty undergoing cancer surgery. Our results could inform future trials powered for more plausible effect sizes, especially for the return to intended oncologic treatment outcome. STUDY REGISTRATION: ClinicalTrials.gov ( NCT02934230 ); first submitted 22 August 2016.

Indexed as

FrailtyNeoplasmsPreoperative ExerciseAgedAged, 80 and overDisease-Free SurvivalElective Surgical ProceduresExercise TherapyFemaleFollow-Up StudiesFrail ElderlyHome Care ServicesHumansMaleMiddle AgedNeoplasm Recurrence, Localcancerexercisefrailtyprehabilitationrandomized trial

Identifiers

PMID39237725

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.