Fitness Test Before Bladder Surgery: Predicting Patient Outcomes

What is it about?

This systematic review and meta-analysis examined the association between cardiopulmonary exercise testing (CPET) parameters and radical cystectomy (RC) outcomes for bladder cancer. Among 546 patients from six studies, lower anaerobic threshold (AT) levels were significantly associated with higher 90-day mortality following RC. While pooled analysis found no significant link between CPET parameters and serious adverse events or hospital length of stay, individual studies noted increased complications and extended stays for patients with poor cardiorespiratory function. The authors suggest CPET, particularly AT measurement, as a preoperative risk stratification tool for RC patients, calling for further research to validate these findings.

Featured Image

Why is it important?

This research is significant because it investigates the relationship between cardiopulmonary exercise testing (CPET) and outcomes of radical cystectomy (RC), a major surgical procedure associated with high morbidity and mortality rates. Understanding the predictive value of CPET parameters for post-operative outcomes could significantly improve patient risk stratification, surgical decision-making, and perioperative management. This study's findings contribute to the growing body of evidence supporting the use of CPET as a valuable preoperative assessment tool, potentially leading to improved patient outcomes and more efficient allocation of healthcare resources in the context of bladder cancer treatment. Key Takeaways: 1. Mortality Risk: The meta-analysis revealed a significantly higher risk of 90-day mortality (over five times) in patients with lower anaerobic threshold (AT) levels following radical cystectomy, indicating the potential of CPET as a predictor of short-term mortality. 2. Adverse Events and Hospital Stay: While pooled analysis showed no significant association between CPET parameters and serious adverse events or hospital length of stay, individual studies reported increased rates of complications and longer hospital stays in patients with poorer cardiopulmonary function. 3. Further Research Needed: The study highlights the need for additional high-quality research to validate these findings and guide the implementation of CPET in preoperative risk stratification for patients undergoing radical cystectomy for bladder carcinoma.