食管胃癌手术后的结果仍然很差。用于食管胃癌手术前风险分层的心肺运动测试（CPET）是基于相互矛盾的证据。本研究探讨了 CPET 与术后结局之间的关系，特别是对于接受新辅助治疗的患者。接受食管胃癌切除术和 CPET（新辅助治疗前或后，或两者）的患者回顾性纳入一项多中心汇总队列研究。将峰值运动时的摄氧量（VO2 峰值）与术后 1 年生存率进行比较。二次分析探讨了患者特征、肿瘤病理学特征、CPET 变量（绝对值、相对于体重、理想体重和体表面积）和术后结果（发病率、1 年和 3 年生存率）之间的关系，并使用 Logistic 评估回归分析。七个英国中心招募了 611 名患者，完成了 3 年术后随访。 475 名患者 (78%) 接受了食管切除术。 25% 的人出现主要并发症，其中 1 年死亡率为 18%，3 年死亡率为 43%。在整个队列中未观察到 VO2 峰值或其他选定的 CPET 变量与 1 年生存率之间存在关联。在整个队列中，相对于理想体重的无氧阈值与 3 年生存率相关（P=0.013）。肿瘤特征（ypT/ypN/肿瘤消退/淋巴管侵犯/切除边缘；P<0.001）和 Clavien-Dindo ≥3a（P<0.001）与 1 年和 3 年生存率相关。亚组分析，新辅助治疗前 CPET；无氧阈值（绝对值；P=0.024，相对于理想体重；P=0.001，体表面积；P=0.009）和无氧阈值下的 VE/VCO2（P=0.026）与 3 年生存率相关。没有其他 CPET 变量（新辅助治疗前或新辅助治疗后）与生存相关。VO2 峰值与食管胃癌切除后的 1 年生存无关。肿瘤特征和主要并发症与生存相关；然而，只有一些选定的新辅助治疗前 CPET 变量与 3 年生存率相关。这组患者的 CPET 结果预测精度有限。NCT03637647.© 2024 作者。

Outcomes after oesophagogastric cancer surgery remain poor. Cardiopulmonary exercise testing (CPET) used for risk stratification before oesophagogastric cancer surgery is based on conflicting evidence. This study explores the relationship between CPET and postoperative outcomes, specifically for patients undergoing neoadjuvant treatment.Patients undergoing oesophagogastric cancer resection and CPET (pre- or post-neoadjuvant treatment, or both) were retrospectively enrolled into a multicentre pooled cohort study. Oxygen uptake at peak exercise (VO2 peak) was compared with 1-yr postoperative survival. Secondary analyses explored relationships between patient characteristics, tumour pathology characteristics, CPET variables (absolute, relative to weight, ideal body weight, and body surface area), and postoperative outcomes (morbidity, 1-yr and 3-yr survival) were assessed using logistic regression analyses.Seven UK centres recruited 611 patients completing a 3-yr postoperative follow-up period. Oesophagectomy was undertaken in 475 patients (78%). Major complications occurred in 25%, with 18% 1-yr and 43% 3-yr mortality. No association between VO2 peak or other selected CPET variables and 1-yr survival was observed in the overall cohort. In the overall cohort, the anaerobic threshold relative to ideal body weight was associated with 3-yr survival (P=0.013). Tumour characteristics (ypT/ypN/tumour regression/lymphovascular invasion/resection margin; P<0.001) and Clavien-Dindo ≥3a (P<0.001) were associated with 1-yr and 3-yr survival. On subgroup analyses, pre-neoadjuvant treatment CPET; anaerobic threshold (absolute; P=0.024, relative to ideal body weight; P=0.001, body surface area; P=0.009) and VE/VCO2 at anaerobic threshold (P=0.026) were associated with 3-yr survival. No other CPET variables (pre- or post-neoadjuvant treatment) were associated with survival.VO2 peak was not associated with 1-yr survival after oesophagogastric cancer resection. Tumour characteristics and major complications were associated with survival; however, only some selected pre-neoadjuvant treatment CPET variables were associated with 3-yr survival. CPET in this cohort of patients demonstrates limited outcome predictive precision.NCT03637647.© 2024 The Authors.