Research Study Abstract

Measuring the impact of oesophagectomy on physical functioning and physical activity participation: a prospective study

  • Published on July 12, 2019

Oesophagectomy remains the only curative intervention for oesophageal cancer, with defined nutritional and health-related quality of life (HR-QOL) consequences. It follows therefore that there is a significant risk of decline in physical wellbeing with oesophagectomy however this has been inadequately quantified. This study prospectively examines change in physical functioning and habitual physical activity participation, from pre-surgery through 6-months post-oesophagectomy.

Patients scheduled for oesophagectomy with curative intent were recruited. Key domains of physical functioning including exercise tolerance (six-minute walk test (6MWT)) and muscle strength (hand-grip strength), and habitual physical activity participation, including sedentary behaviour (accelerometry) were measured pre-surgery (T0) and repeated at 1-month (T1) and 6-months (T2) post-surgery. HR-QOL was measured using the EORTC-QOL C30.

Thirty-six participants were studied (mean age 62.4 (8.8) years, n = 26 male, n = 26 transthoracic oesophagectomy). Mean 6MWT distance decreased significantly from T0 to T1 (p = 0.006) and returned to T0 levels between T1 and T2 (p < 0.001). Percentage time spent sedentary increased throughout recovery (p < 0.001) and remained significantly higher at T2 in comparison to T0 (p = 0.003). In contrast, percentage time spent engaged in either light or moderate-to-vigorous intensity activity, all reduced significantly (p < 0.001 for both) and remained significantly lower at T2 in comparison to T0 (p = 0.009 and p = 0.01 respectively). Patients reported deficits in multiple domains of HR-QOL during recovery including global health status (p = 0.04), physical functioning (p < 0.001) and role functioning (p < 0.001). Role functioning remained a clinically important 33-points lower than pre-operative values at T2.

Habitual physical activity participation remains significantly impaired at 6-months post-oesophagectomy. Physical activity is a measurable and modifiable target for physical rehabilitation, which is closely aligned with patient-reported deficits in role functioning. Rehabilitation aimed at optimising physical health in oesophageal cancer survivorship is warranted.


  • E. M. Guinan 1
  • A. E. Bennett 2
  • S. L. Doyle 3
  • L. O’Neill 4
  • J. Gannon 4
  • G. Foley 4
  • J. A. Elliott 5
  • J. O’Sullivan 6
  • J. V. Reynolds 5,6
  • J. Hussey 4


  • 1

    School of Medicine, Trinity College Dublin, Dublin, Ireland

  • 2

    Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland

  • 3

    School of Biological Sciences, Dublin Institute of Technology, Dublin, Ireland

  • 4

    Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland

  • 5

    Department of Surgery, St. James’ Hospital, Dublin, Ireland

  • 6

    Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, Dublin, Ireland


BMC Cancer

Download Abstract