Evidence map›Paper›PMID 40087747›Full record

ArticleBMC sports science, medicine & rehabilitation2025

Understanding the mechanism behind preoperative exercise therapy in patients with gastrointestinal cancers: a prospective randomized clinical trial.

Ahmad Hamad, Hongji Zhang, Yunwei Zhang, Chengli Shen, Pengyan Fa, Hai Huang, Aslam Ejaz, Allan Tsung

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC sports science, medicine & rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04602026 (Re-Defining Frailty and Improving Outcomes Through Prehabilitation), 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.

NCT04602026 nacompletednot on this map

Re-Defining Frailty and Improving Outcomes Through Prehabilitation (RIOT Trial)

TypeinterventionalSponsorOhio State University Comprehensive Cancer CenterRan2020 to 2024Enrolled66ConditionsAdult Liver Carcinoma, Gastric Carcinoma, Malignant Solid Neoplasm, Pancreatic CarcinomaArmsBest Practice, Exercise Intervention, Physical Therapy, Questionnaire Administration
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Physical Exercise in Immunotherapy.Sports medicine - open · 2026
    Review
  3. Review
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

8 authors.

Ahmad Hamad *Department of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA.
Hongji Zhang *Department of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA.
Yunwei Zhang *Department of Surgery, University of Virginia School of Medicine, P O Box 800709, Charlottesville, VA, 22908, USA.
Chengli ShenDepartment of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA.
Pengyan FaDepartment of Surgery, University of Virginia School of Medicine, P O Box 800709, Charlottesville, VA, 22908, USA.
Hai HuangDepartment of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA.
Aslam EjazDepartment of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA.
Allan TsungDepartment of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA. crf9aa@uvahealth.org.

Funding

Women's Oncology Program - WONP30CA044579 · NCI · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI Dina Gould Halme · 1987 to 2026
$72.1M
Surgery triggered immune response and liver metastasesR01CA214865 · NCI · UNIVERSITY OF VIRGINIA · PI Allan Tsung · 2018 to 2026
$3.4M
Preoperative exercise therapy triggers trained immunity in KCs via cholinergic anti-inflammatory pathwayR01GM137203 · NIGMS · OHIO STATE UNIVERSITY · PI HUANG, HAI · 2020 to 2025
$2.0M
NCI NIH HHS P30 CA044579NCI NIH HHS R01 CA214865NIGMS NIH HHS R01 GM137203NIH HHS R01-CA214865NIH HHS R01-GM137203UVA Comprehensive Cancer Center IDEA-Cancer pilot award
6 · The paper itself

Abstract

backgroundThere is a gap in knowledge regarding the utility of preoperative exercise (PEx) among gastrointestinal (GI) cancer patients undergoing surgery and how PEx impacts surgical outcomes. This study seeks to evaluate the mechanism behind PEx among patients undergoing major abdominal surgery for GI cancer through a randomized controlled trial (RCT).

methodsThis was a single center RCT conducted at The Ohio State University Wexner Medical Center. Eligible patients diagnosed with GI cancers with planned abdominal surgery were randomized to receive PEx or a Sedentary (Non-PEx) arm between October 2020 and May 2022. To investigate if PEx could lead to systemic change in circulation, we employed secretomics and metabolomics analyses of patient serum samples before and after exercise to detect inflammatory and tumorigenic responses, with the primary endpoint of investigating the mechanisms through which PEx modulates the inflammatory response in patients undergoing GI cancer surgery.

resultsBetween October 2020 and May 2022, 64 patients were enrolled in the study, with 28 randomized to the PEx group and 36 to the non-PEx group. The two cohorts were comparable in terms of age, gender, and comorbidity burden. The median length of stay was 6 days across the entire cohort, with no significant differences between the groups. Similarly, the overall 30-day readmission rate was 15.7%, and the median comprehensive complication index score was 20.9, both of which showed no differences between the PEx and non-PEx groups. Secretomics and metabolomics analyses of patient serum samples revealed a shift towards an anti-inflammatory and anti-tumorigenic phenotype, with significant changes in secretion and metabolic profiles observed in post-PEx serum compared to pre-PEx serum from the same patients.

conclusionsPEx has the potential to mitigate the pro-inflammatory and pro-tumorigenic state of GI cancer by modulating specific cellular pathways. This study provides evidence into the mechanisms underlying these effects, but additional research is required to explore their applicability in therapeutic development. These findings build upon existing research to support the advancement of exercise-inspired therapeutic strategies in the future.

trial registrationThe trial was registered at Clinicaltrials.gov (NCT04602026) on 20/10/2020.

Indexed as

Anti-inflammatory and anti-tumorigenic effectsGastrointestinal cancer surgeryPreoperative exerciseSystemic metabolic changes

Identifiers

PMID40087747
PMCPMC11909910

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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.