Exercise training before lung surgery in people with non-small cell lung cancer

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Review question

We reviewed the evidence about the effect of exercise training undertaken before lung surgery on the risk of developing a postoperative lung complication, the number of days needing a chest drain after surgery, length of hospital stay, fitness level, and lung function in patients with non-small cell lung cancer (NSCLC).


Lung surgery for NSCLC offers patients a chance of cure, however, lung surgery is associated with increased risk of postoperative lung complications. Preoperative exercise training, through its improvement in fitness levels, may have the potential to decrease the risk of postoperative lung complications and improve other postoperative outcomes, like number of days patients need a chest drain, and length of hospital stay. However, the effects of preoperative exercise training on postoperative outcomes of people with NSCLC is unclear.

Study characteristics

The evidence is current to November 2016. This review included data from 167 participants (mean age ranged from 54 to 72.5 years) in five studies (sample size of the included studies ranged from 19 to 60 participants).

Key results

Results from our review showed that compared to a control group that did not exercise before lung surgery, people with NSCLC who exercised before lung surgery had 67% less risk of developing a postoperative lung complication. Based on this result, we would expect that out of 100 people with NSCLC who exercise before lung surgery, seven will experience a postoperative lung complication, compared with 22 people with NSCLC who will experience a postoperative lung complication if they do not exercise before lung surgery. Also, compared to the control group, people with NSCLC who exercised before lung surgery had a chest drain for fewer days (three days less), had a shorter length of hospital stay (four days less), and better 6-minute walk distance (18 metres more), and lung function before surgery (3% better).

Quality of the evidence

The overall quality of evidence was low for all of the outcomes, mainly because of the small number of studies found, the small number of participants in the included studies, and limitations in the studies’ methods.