ASPO Abstracts
The role of home-based exercise in maintaining muscle quality during preoperative pancreatic cancer treatment
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020
Abstract Body:
Purpose: We previously showed that home-based exercise program (EP) participation is associated with
maintenance of muscle quantity (skeletal muscle index, SMI) during preoperative pancreatic cancer treatment.
Despite their physiologic importance, muscle quality measures (skeletal muscle density, SMD, and gauge,
SMG) have not been examined in this context. We compared changes in SMD and SMG between EP
participants and a usual care (UC) comparison group. We hypothesized that EP participation would be
associated with maintenance of SMD and SMG.
Methods: Home-based EP recommendations included moderate-intensity aerobic exercise and resistance
training (≥60 min/wk each) during preoperative therapy. UC patients had no formal exercise program. Average
SMD (Hounsfield Units, HU) of muscle cross-sections at the L3 vertebra was quantified using Tomovision
SliceOmatic software and CT scans from baseline and following preoperative treatment. SMG was calculated
as SMI*SMD (arbitrary units, AU). Linear regression models adjusted for sex, age, change in BMI, therapy
received (chemotherapy, chemoradiation, both), and baseline SMD/SMG were used to evaluate differences in
rates of SMD and SMG change between groups.
Results: Clinicodemographic profiles of EP (n=33) and UC (n=63) were similar (p>.05 for differences in sex,
age, BMI, sarcopenia, and therapy received). Rate of SMD change was .05±.3 HU/wk for EP compared to
-.02±.4 HU/wk for UC (p=.4). Rate of SMG change was 2.6±18.6 AU/wk for EP compared to -4.1±19.0 AU/wk
for UC (p=.1). In adjusted models, there was no significant association between group and rate of SMD change
(B=.09, p=.3), but EP participation was favorably associated with rate of SMG change (B=8.1, p=.04).
Conclusions: The home-based EP helped patients undergoing preoperative pancreatic cancer treatment
maintain SMG, which incorporates both muscle quantity and quality. There is insufficient evidence for
maintaining muscle quality alone (SMD), which may be an important predictor of physical function and risk for
impairments. Future interventions should focus on progressive resistance training in order to improve muscle
density.
Keywords: Exercise, muscle, pancreatic cancer, prehabilitation