Rehabilitation strategies following esophageal cancer (the ReStOre trial): a feasibility study

As survival rates in esophageal cancer improve, the role of rehabilitation programs in this group is emerging as an important issue. This study aims to determine the feasibility of a multidisciplinary rehabilitation program to optimize physical function and quality of life in esophageal cancer survivors. This single-arm feasibility study recruited patients who had completed curative treatment for esophageal cancer, including esophagectomy, with node-negative postsurgical pathology. The multidisciplinary program consisted of 12 weeks of supervised and home-based exercise, dietetic counseling, and education sessions. Feasibility outcomes included recruitment rates, adherence, adverse events, and retention. Other outcomes included cardiopulmonary fitness (maximal cardiopulmonary exercise test and the six minute walking test), quality of life (QOL) (European Organisation for Research and Treatment of Cancer (EORTC) questionnaires) and body composition (bioimpedance analysis). Change in outcomes from baseline to postintervention was measured using the paired sample t-tests. Twelve participants (mean (standard deviation) age 61.4 (7.29) years, eight male) consented to participate, representing a recruitment rate of 55%. Mean class attendance was 82(13)% and mean adherence to the home exercise program was 118(76)%. No adverse events occurred. Retention to the program was 100%. VO(2)max improved by 3.99(2.7) mL/kg/min (p < 0.004). The six minute walking test distance increased by 56.3(35.3) m(p< 0.003). Global, functional, and symptom QOL scores improved. Body composition remained stable. This pilot study demonstrated high feasibility and acceptability in this complex cohort. Clinically significant improvements in functional performance and QOL were evident without compromise to body composition. The results of this study will help guide the design of a forthcoming larger randomized controlled trial.