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Preoperative Physical Activity Intervention in Patients Before Planned Liver Resection for Cancer (APACHE)

Not Applicable
Completed
Conditions
Secondary Liver Cancer
Liver Metastases
Primary Liver Cancer
Interventions
Behavioral: Interval training
Other: Standard Oncologic care
Registration Number
NCT03518632
Lead Sponsor
Célia Turco
Brief Summary

The aim of this study is to assess the impact of preoperative physical activity on physical capacities of patients undergoing liver resection for primary or secondary liver cancer.

Detailed Description

The purpose of this study is to investigate the effects of a preoperative exercise program in patients with primary or secondary liver cancer undergoing hepatectomy. Preoperative exercise programs have been shown to be effective in other cancer populations, but have been poorly studied in patients with liver cancer. For these patients, it remains unclear what the optimal composition of such programs should be and how they should be delivered. Outcome measures in this study will include preoperative outcomes (oxygen consumption, quality of life, fatigue and physical activity level, anthropometric measures, plasma concentrations of hepatokines) and postoperative outcomes (length of hospital stay and postoperative complications).

After the study is explained and consent obtained, subjects will be tested on a submaximal exercise on cycloergometer with gas exchanges analysis and with pre and post blood test. Then, they will answer various questionnaires assessing physical activity, quality of life and fatigue.

Patients scheduled for liver resection will be randomized to one of two groups. The first group (experimental group) will be subdivided into two groups: interval training 1 and interval training 2, which differentiate themselves by two different intensities.The second group (control group) will receive standard care.

The prehabilitation program will last 6 weeks with 3 sessions per week and will consist in two interval training programs on a cycloergometer with two different intensities.

One month after surgery, peri and postoperative complications will be noted.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
8
Inclusion Criteria
  • Men and women aged >18 years old.
  • Patients with primary liver cancer, biliary tract cancer, liver metastasis endorsed in the University Hospital of Besancon
  • No opposition of patients
  • Join a French social security or receiving such a scheme
Exclusion Criteria
  • Legal incapacity or limited legal capacity
  • Patients being in the disqualification of another study or under the national register of volunteers
  • Patients unlikely to cooperate or anticipated low cooperation
  • Patients with a maximal oxygen consumption above 35 ml/min/kg

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Interval training 1Interval training-
Control groupStandard Oncologic care-
Interval training 2Interval training-
Primary Outcome Measures
NameTimeMethod
Change of Oxgen consumption at anaerobic threshold :6 weeks

Oxygen consumption at anaerobic threshold will be assessed at baseline and at the end of the 6 weeks' program with a submaximal exercise performed on cycloergometer

Secondary Outcome Measures
NameTimeMethod
Intensive care stay :One month after surgery

Postoperative intensive care stay will be evaluated (number of days).

Postoperative complications with the Dindo Clavien classification :One month after surgery

Postoperative complications will be assessed using the Dindo Clavien classification which consists in a 7 grades classification (I, II, IIIa, IIIb, IVa, IVb and V).

Changes of Hepatokines plasmatic concentrations :Comparison between plasmatic concentrations pre-exercise (day 1), post exercise (day 1) and at 6 weeks

Fetuin A (ng/mL) concentrations will be analyzed.

Hepatokines plasmatic concentrations :Comparison between plasmatic concentrations pre-exercise (day 1), post exercise (day 1) and at 6 weeks

Fibroblast Growth Factor 21 (FGF21) (pg/mL) concentrations will be analyzed.

Changes in Physical activity level :Comparison between baseline, after the 6 weeks' program

Physical activity level will be measured using the long-form of the International Physical Activity Questionnaire (IPAQ). It consist in a description of the physical activity level by assessing 5 activity domains during the 7 last days. Physical activity level is expressed in Metabolic Equivalent Tasks (METs). It enables to classify patients in 3 categories : low physical activity level, moderate physical activity level and high physical activity level.

Changes in Quality of life :Comparison between baseline, after the 6 weeks' program

Health related quality of life will be measured with the EORTC Quality of Life Questionnaire QLQ-C30 which is a cancer specific questionnaire. It consists in 30 items to measure 15 dimensions of quality of life. It generates a score between 0 and 100. A higher score means a higher quality of life level.

Changes in Fatigue :Comparison between baseline, after the 6 weeks' program

Fatigue will be measured with the Quality of Life Questionnaire QLQ-FA12 which enables to assess cancer related fatigue. It consists in 12 items to measure 5 dimension go health related fatigue. It generates a score between 0 and 100. A higher score means a higher fatigue level.

Trial Locations

Locations (1)

Chirurgie digestive, viscérale et cancérologique

🇫🇷

Besançon, France

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