• J K van Vulpen, A E Hiensch, R van Hillegersberg, J P Ruurda, BackxF J GFJGDepartment of Rehabilitation, Physical Therapy Science & Sport, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands., NieuwenhuijzenG A PGAP0000-0002-5837-5513Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., E A Kouwenhoven, GroenendijkR P RRPRDepartment of Surgery, IJsselland Hospital, Capelle a/d IJssel, The Netherlands., D L van der Peet, E J Hazebroek, C Rosman, WijnhovenB P LBPLDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands., M I van Berge Henegouwen, van LaarhovenH W MHWMDepartment of Medical Oncology, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., P D Siersema, and A M May.
• Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
• Br J Surg. 2021 Jul 23; 108 (7): 786796786-796.

BackgroundThis study investigated whether a supervised exercise programme improves quality of life (QoL), fatigue and cardiorespiratory fitness in patients in the first year after oesophagectomy.MethodsThe multicentre PERFECT trial randomly assigned patients to an exercise intervention (EX) or usual care (UC) group. EX patients participated in a 12-week moderate- to high-intensity aerobic and resistance exercise programme supervised by a physiotherapist. Primary (global QoL, QoL summary score) and secondary (QoL subscales, fatigue and cardiorespiratory fitness) outcomes were assessed at baseline, 12 and 24 weeks and analysed as between-group differences using either linear mixed effects models or ANCOVA.ResultsA total of 120 patients (mean(s.d.) age 64(8) years) were included and randomized to EX (61 patients) or UC (59 patients). Patients in the EX group participated in 96 per cent (i.q.r. 92-100 per cent) of the exercise sessions and the relative exercise dose intensity was high (92 per cent). At 12 weeks, beneficial EX effects were found for QoL summary score (3.5, 95 per cent c.i. 0.2 to 6.8) and QoL role functioning (9.4, 95 per cent c.i. 1.3 to 17.5). Global QoL was not statistically significant different between groups (3.0, 95 per cent c.i. -2.2 to 8.2). Physical fatigue was lower in the EX group (-1.2, 95 per cent c.i. -2.6 to 0.1), albeit not significantly. There was statistically significant improvement in cardiorespiratory fitness following EX compared with UC (peak oxygen uptake (1.8 ml/min/kg, 95 per cent c.i. 0.6 to 3.0)). After 24 weeks, all EX effects were attenuated.ConclusionsA supervised exercise programme improved cardiorespiratory fitness and aspects of QoL.Trial RegistrationDutch Trial Register NTR 5045 (www.trialregister.nl/trial/4942).© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.

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