SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1563478
This article is part of the Research TopicMechanistic Roles of Exercise on Cancer Progression, Recurrence and Survival OutcomesView all 5 articles
Postoperative outcomes of preoperative exercise training in patients with operable non-small cell lung cancer: A systematic review and meta-analysis
Provisionally accepted
Cuifang Li
Haidan MengYe WeiYugan LiangYangqian XuXiaomeng Huang
Weiming LiangJieru QuanShanguang Wu
Xueyan Wei*- Guangxi University of Science and Technology, Liuzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Introduction This meta-analysis was designed to compare the outcomes of preoperative exercise training versus no preoperative exercise for lung cancer patients scheduled for lung resection. Materials and Methods Four databases (Medline, Embase, Web of Science, and CENTRAL) were searched for randomized controlled trials (RCTs) comparing preoperative exercise training versus no preoperative exercise for lung cancer patients scheduled for lung resection. The primary outcomes were postoperative complications and postoperative length of hospital stay. The secondary outcomes included post-intervention pulmonary function, severe postoperative complications, postoperative 30-day mortality, postoperative duration of chest tube drainage, post-intervention dyspnoea and post-intervention health-related quality of life (HRQoL). Results Sixteen RCTs with 1,022 individuals were included in this meta-analysis. Compared with no preoperative exercise, preoperative exercise training significantly reduced the postoperative complications (OR = 0.33, 95%CI: 0.24 to 0.46, P < 0.0001) and postoperative length of hospital stay (95%CI: −3.11 to −1.40, P < 0.0001). Besides, preoperative exercise training significantly improved forced expiratory volume in 1 second (FEV1%) of predicted norm values (95%CI: 5.30 to 8.10, P < 0.0001), forced vital capacity (FVC%) of predicted norm values (95%CI: 1.90 to 4.23, P < 0.0001), peak expiratory flow (PEF) (95%CI: 12.44 to 60.93, P = 0.003) and peak oxygen uptake (VO2peak) (95%CI: 2.41 to 4.17, P < 0.0001), while reducing severe postoperative complications (OR = 0.35, 95%CI: 0.21 to 0.56, P < 0.0001) and post-intervention dyspnoea (95%CI: -0.61 to 0.04, P = 0.02). There was no significant difference between the two groups regarding FEV1, FVC, carbon monoxide diffusing capacity (DLCO), six-minute walk distance (6MWD), postoperative 30-day mortality, postoperative chest tube drainage time and post-intervention HRQoL. Conclusions This meta-analysis indicated that preoperative exercise training was effective for lung cancer patients scheduled for lung resection, potentially reducing postoperative complications and hospital stay duration, while improving post-intervention pulmonary function and exercise capacity. Trial registration: PROSPERO (CRD42024607156)
Keywords: lung cancer, Lung resection, exercise training, complication, Pulmonary Function, exercise capacity, Meta-analysis
Received: 20 Jan 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Li, Meng, Wei, Liang, Xu, Huang, Liang, Quan, Wu and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xueyan Wei, Guangxi University of Science and Technology, Liuzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.