Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer

TL;DR

This study found that Seismofit® does not accurately estimate preoperative fitness levels in cancer patients compared to traditional testing.

Contribution

The study is the first to evaluate Seismofit® in cancer patients undergoing major abdominal surgery.

Findings

Seismofit® showed no linear correlation with CPET-measured VO2 peak (Pearson r=0.111).

Seismofit® overestimated VO2 peak with a large bias of 12.8 (standard deviation 8.8).

No association was found in subgroups or with other CPET variables.

Abstract

Peak oxygen uptake (VO2 peak) measured during cardiopulmonary exercise testing (CPET) is commonly used to objectively assess fitness and inform risk stratification. Preoperative CPET is not always universally available. Seismofit® offers a noninvasive, non-exercise alternative for estimating VO2 peak, though it has not been validated in patients awaiting major abdominal cancer surgery.

Prospective single-centre blinded observational study in patients with hepato-pancreato-biliary, colorectal, or gastro-oesophageal cancer undergoing preoperative assessment. Patients underwent Seismofit® assessment before routine CPET. Primary outcome was the relationship between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak. Secondary outcomes explored the relationship between Seismofit® and CPET for (i) bias and agreement limits; (ii) surgical subgroup; (iii) commonly reported CPET variables; (iv) patient acceptance.

Thirty-three participants (median [interquartile range] age: 67 yr [58–75 yr]; 20 [61%] males) completed both CPET and Seismofit®. No linear association was found between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak: Pearson r=0.111 (95% confidence interval −0.242 to 0.437), R2=0.012, P=0.539. Compared with CPET, Seismofit® demonstrated a large bias (standard deviation) 12.8 (8.8); 95% limits of agreement (−4.5 to 30.0). No association existed between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak in the hepato-pancreato-biliary or gastro-oesophageal subgroup or between Seismofit®-estimated VO2 peak and commonly reported CPET variables.

There was no evidence of linear association between Seismofit®-estimated VO2 peak and objectively measured VO2 peak by CPET in patients undergoing assessment for major abdominal cancer surgery. This finding was consistent across all subgroup and exploratory analyses. Seismofit® tended to overestimate VO2 peak with a high degree of bias.

NCT05831488.

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