Maarten van Egmond

128 Chapter 6 RESULTS Baseline characteristics From January 2017 to October 2018, 22 patients with esophageal cancer that underwent esophagectomy were included in the study after having obtained informed consent. The study was terminated after inclusion of the 22nd patient because there was a point achieved in data collection after which no new or relevant information emerged with respect to answering the primary research question. Mean age at surgery was 64.6 (SD 6.7) years, and 17/22 (77%) patients were male. All patients received neoadjuvant chemoradiation therapy. At enrollment, mean pulmonary function expressed as a percent score of predicted pulmonary function value was 116.1 (SD 18.7) for forced vital capacity, 109.0 (SD 19.3) for forced expiratory volume in 1 second and 109.2 (SD 30.1) for inspiratory vital capacity. Except for 2, all patients were surgically treated with a minimally invasive transthoracic esophagectomy. In addition, 8/22 (36%) patients had a hospital stay of more than 9 days. Moreover, 20/22 (91%) patients suffered from postoperative complications, of which 14/22 (70%) required a surgical, endoscopic, or radiological intervention. Patient characteristics are presented in Table 1. Feasibility A total of 15/22 (68%) patients completed the 12-week program. From the 7 patients that did not complete the study, 1 was discharged to a nursing home after inclusion, 2 quitted the study intervention after 3 and 4 weeks because they preferred face-to-face physiotherapy, and 4 patients were withdrawn by the investigator because postoperative treatment required a multidisciplinary approach (n = 3) or because of the presence of metastases (n = 1). These patients did not systematically differ in baseline characteristics from the patients who completed the program. The average duration of the treatment program was 11.1 (SD 5.2) weeks. From all exercises provided to patients, 1337/4671 (28.62%) was aimed at lower extremity muscle strength, 996/4671 (21.32%) at respiration, and 1150/4671 (24.62%) at walking. The patient adherence, operationalized in performance rate of exercises to the telerehabilitation intervention, was 99.8% in the first 6 weeks and dropped to 75.6% in the second period of 6 weeks, with a mean difference of −24.3% (95% CI 1.3 to 47.2; P = .04). The accomplishment of treatment goals was the main reason reported for being less or not adherent to the program anymore.