In this randomized clinical trial, preoperative exercise training during neoadjuvant treatment did not increase the likelihood of undergoing tumor surgery for patients with gastroesophageal cancer, and the findings do not support its use to improve surgical outcomes.
Exercise training did not reduce the proportion of patients not undergoing tumor surgery with curative intent compared with usual care.
Exercise training did not change treatment tolerance, as measured by permanent discontinuation of neoadjuvant treatment or postoperative complications.
Overall survival at 3 years was lower in the exercise group than in the control group.
The trial was a single-center, single-blinded randomized superiority trial of twice-weekly concurrent aerobic and resistance exercise from diagnosis until tumor surgery.
The analysis population comprised 202 participants, evenly split between groups, who were mostly older men with gastroesophageal junction cancer.
The authors concluded that the findings do not support exercise training during neoadjuvant treatment to improve surgical outcomes.
This trial tested whether doing supervised exercise during chemotherapy before surgery could help people with stomach-area or lower food pipe (gastroesophageal) cancer be well enough to have their tumor removed. 202 patients in Copenhagen were randomly assigned to either twice-weekly combined aerobic and strength training from diagnosis until surgery, or usual care. Exercise made no difference to the chance of not getting surgery: about 10% in the exercise group and 8% in the usual care group did not have curative-intent surgery, a difference that could easily be due to chance. Exercise also did not change whether patients had to stop pre-surgery treatment permanently or whether they had complications after surgery. Unexpectedly, three-year survival was lower in the exercise group (51%) than in the usual care group (65%). Survival was a secondary outcome, and the authors say more research is needed. This research suggests that adding exercise during pre-surgery cancer treatment did not improve the likelihood of reaching surgery or surgical outcomes in this group. The survival finding needs careful follow-up, as this study cannot explain why it occurred. These results apply to one hospital and to the particular exercise program tested.
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Upload Your LabsSimonsen C, de Heer P, Thomsen S, Krabek R, Thorsen-Streit S, Printz Lyngbæk M, et al.. (2026). Exercise Training During Neoadjuvant Treatment for Gastroesophageal Cancer and Tumor Surgery: A Randomized Clinical Trial.. JAMA network open. https://doi.org/10.1001/jamanetworkopen.2026.40136