A comprehensive study related to the mechanism and usefulness of pre-operative intervention on physical frailty as a poor prognostic factor after surgery for gastrointestinal cancer in older adults

2018 Fiscal Year Final Research Report

• Project/Area Number: 16H05277
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: Osaka University
• Principal Investigator: Rakugi Hiromi 大阪大学, 医学系研究科, 教授 (20252679)
• Co-Investigator(Kenkyū-buntansha): 杉本 研 大阪大学, 医学系研究科, 講師 (20437403) ; 山崎 誠 大阪大学, 医学系研究科, 准教授 (50444518)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 高齢癌患者 / フレイル / 術前評価 / レジスタンス運動

Outline of Final Research Achievements

A clinical trial with frail older cancer patients investigating the effect of pre-operative exercise & nutrition intervention on postoperative complication and prognosis suggested that this intervention did not show a clear effect on postoperative complications; however, this intervention maintained physical functions (lower-limb muscle strength, gait speed) and decreased the progression of depression and apathy. A basic study investigating the effect of exercise training on cancer cachexia revealed that low-intensity exercise inhibited cancer cachexia-induced muscle atrophy by improving muscle tissue hypoxia via suppression of capillary regression. Taken together, pre-operative ‘moderate’ exercise and amino-acid supplementation for older cancer patients may contribute improvement of postoperative prognosis through maintaining physical and mental functions.

Free Research Field

老年医学

Academic Significance and Societal Importance of the Research Achievements

癌術後の合併症の発症や予後の悪化にかかわるフレイルを示す高齢者に対して、術前にフレイルの改善につながる運動とアミノ酸補充を短期間行うことにより、術前後の身体機能や精神状態（うつ、意欲）が改善することが臨床・基礎の両面から示され、長期予後の改善にも寄与することが期待される。本研究成果は、高齢癌術前介入の標準化によるフレイル高齢者に対する手術適応の拡大と予後改善に貢献すると考えられる。