Multidisciplinary Rehabilitation Following Upper Gastrointestinal Cancer Surgery (RESTORE II): A Definitive Randomized Controlled Trial.
Linda M O'Neill, Emily Smyth, Neil Kearney et al.
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In 30 seconds
RESTORE II was a randomized controlled trial comparing a 12-week multidisciplinary rehabilitation program with standard care in disease-free patients at least 3 months after upper gastrointestinal cancer resection. The program combined physiotherapy-led aerobic and resistance exercise, dietary counselling, and psychosocial support. Among 88 participants, the estimated increase in VO₂peak was greater with rehabilitation than standard care by 1.5 mL/min/kg from baseline to postintervention (95% CI: 0.52-2.48; P-value=0.003), with a benefit also evident at 3-month follow-up. Secondary outcomes did not differ significantly between groups.
Key findings
- Compared with standard care, rehabilitation produced a greater mean VO₂peak increase of 1.5 mL/min/kg from baseline to postintervention (95% CI: 0.52-2.48; P-value=0.003).
- At 3-month follow-up, the estimated between-group difference in VO₂peak change was 1.23 mL/min/kg (95% CI: 0.18-2.27; P-value=0.02).
- Secondary outcomes, including strength, functional performance, physical activity, body composition, and quality of life, showed no significant differences between groups.
Why it matters
Cardiorespiratory fitness can remain a modifiable outcome after upper gastrointestinal cancer surgery, even among disease-free survivors several months or more after resection. The trial suggests that a structured program combining exercise with dietary and psychosocial support can improve fitness relative to standard care, while the absence of significant differences in secondary outcomes indicates that benefits were not demonstrated across all measured domains.
What to keep in mind
The trial found no significant between-group differences in its secondary outcomes, so evidence of benefit was limited to cardiorespiratory fitness.