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Esophageal CancerNCT07561840

Exercise Training After Upper Gastrointestinal Cancer Surgery

A study testing High-Intensity Interval Training (HIIT) and Low-Intensity Continuous Training (LICT) in people with Esophageal Cancer and Gastric Cancer (Diagnosis), run by Kansai Medical University at 2 sites in Japan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This randomized controlled trial aims to determine the optimal exercise intensity for improving postoperative recovery in patients with upper gastrointestinal cancer. Participants who have undergone curative surgery will be randomly assigned to high-intensity interval training (HIIT), low-intensity continuous training… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
High-Intensity Interval Training (HIIT) and Low-Intensity Continuous Training (LICT)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
171 participants
Where
2 sitesJapan
Study dates
15 May 2026to Nov 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years
  • Diagnosed with esophageal or gastric cancer
  • Received curative surgery
  • 6 ± 2 weeks after surgery
  • Ability to provide written informed consent

Who cannot join

  • Communication difficulties
  • Poor general status
  • Undergone combined laryngopharyngectomy
  • Unsuitable for evaluation or exercise intervention
  • Unsuitable for the study as determined by the primary physician

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Japan2 sites, 2 recruiting
  • Kansai Medical University

    Hirakata, Osaka, 573-1136

    Takuya Fukushima, +81-72-856-2115, fukushima.tky@kmu.ac.jp

    Jiro Nakano, +81-72-856-2115, nakano.jir@kmu.ac.jp

    Not yet recruiting
  • Kansai Medical University

    Hirakata, Osaka, 573-1136

    Takuya Fukushima, +81-72-856-2115, fukushima.tky@kmu.ac.jp

    Jiro Nakano, +81-72-856-2115, nakano.jir@kmu.ac.jp

    Recruiting

Other trials in Japan

About this study

Official title: Exercise and Cardiorespiratory Fitness Improvement Through Supervised Training in Upper Gastrointestinal Cancer Surgery Patients (EXCITING-UGI)

This randomized controlled trial aims to determine the optimal exercise intensity for improving postoperative recovery in patients with upper gastrointestinal cancer. Participants who have undergone curative surgery will be randomly assigned to high-intensity interval training (HIIT), low-intensity continuous training (LICT), or usual care. The exercise interventions will be performed under supervision three times per week for eight weeks. The primary outcome is peak oxygen uptake (VO₂peak), assessed using cardiopulmonary exercise testing. Secondary outcomes include physical function, body composition, patient-reported outcomes, and biological and mechanistic markers such as inflammatory biomarkers, muscle-related factors, and gut microbiota. This study will also explore potential mechanisms underlying exercise-induced adaptations and their association with clinical outcomes.

Read the detailed description

This study is a single-center, three-arm randomized controlled trial designed to evaluate the effects of exercise intensity on postoperative recovery in patients with upper gastrointestinal cancer. Patients who have undergone curative surgery for esophageal or gastric cancer will be enrolled 6 ± 2 weeks after surgery and randomly assigned to high-intensity interval training (HIIT), low-intensity continuous training (LICT), or usual care. The exercise intervention consists of supervised aerobic and resistance training performed three times per week for eight weeks. HIIT involves repeated high-intensity intervals interspersed with recovery periods, whereas LICT consists of continuous low-intensity aerobic exercise. The primary outcome is the change in peak oxygen uptake (VO₂peak) from baseline to 8 weeks, assessed using cardiopulmonary exercise testing. Secondary outcomes include measures of physical function, skeletal muscle mass, physical activity, quality of life, and biological and mechanistic outcomes such as inflammatory biomarkers, muscle-related factors, and gut microbiome composition. This study aims to clarify the dose-response relationship of exercise intensity and to explore the physiological mechanisms underlying exercise-induced adaptations in the early postoperative phase.

Being tested
High-Intensity Interval Training (HIIT), Low-Intensity Continuous Training (LICT)
Keywords
upper gastrointestinal cancers, exercise, high-intensity interval training, randomized controlled trial, exercise oncology
Medical subject headings
Esophageal Neoplasms, Stomach Neoplasms, Disease, Gastrointestinal Neoplasms, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • High-Intensity Interval Training (HIIT)Behavioural

    Also called HIIT

    Supervised aerobic high-intensity interval training combined with resistance training and nutritional counseling. Aerobic training is performed on a cycle ergometer and consists of four sets of 4-minute high-intensity intervals at 80-95% of VO₂peak, interspersed with 3-minute recovery periods at 60% of VO₂peak. Each session includes a 3-minute warm-up and a 3-minute cool-down, with a total duration of 34 minutes. Training is performed three times per week for eight weeks. Resistance training includes chest press, leg extension, leg press, and abdominal exercises using pneumatic resistance machines, consisting of two sets of 20-25 repetitions at approximately 20RM. Nutritional counseling is provided by a registered dietitian once every four weeks for a total of two sessions during the intervention period.

  • Low-Intensity Continuous Training (LICT)Behavioural

    Also called LICT

    Supervised low-intensity continuous training combined with resistance training and nutritional counseling. Aerobic training is performed on a cycle ergometer at 37-45% of VO₂peak for 28 minutes per session, with a 3-minute warm-up and a 3-minute cool-down, for a total duration of 34 minutes. Training is performed three times per week for eight weeks. Resistance training is identical to the HIIT group and includes chest press, leg extension, leg press, and abdominal exercises using pneumatic resistance machines, consisting of two sets of 20-25 repetitions at approximately 20RM. Nutritional counseling is provided by a registered dietitian once every four weeks for a total of two sessions during the intervention period.

Study groups in NCT07561840
Study groupRoleWhat they receive
High-Intensity Interval Training (HIIT)ExperimentalParticipants will perform supervised aerobic high-intensity interval training combined with resistance training. Aerobic training is performed on a cycle ergometer and consists of four sets of 4-minute work intervals at 80-95% of VO₂peak, interspersed with 3-minute recovery intervals at 60% of VO₂peak. Each session includes a 3-minute warm-up and a 3-minute cool-down, for a total duration of 34 minutes per session. Exercise is performed three times per week for eight weeks. Resistance training includes chest press, leg extension, leg press, and abdominal exercises using pneumatic resistance machines (HUR, Finland), consisting of two sets of 20-25 repetitions at approximately 20RM. Nutritional counseling is provided by a registered dietitian once every four weeks for a total of two sessions during the intervention period.
Receives: Behavioral: High-Intensity Interval Training (HIIT)
Low-Intensity Continuous Training (LICT)ExperimentalParticipants will perform supervised low-intensity continuous training combined with resistance training and nutritional counseling. Aerobic training is performed on a cycle ergometer at 37-45% of VO₂peak for 28 minutes per session, with a 3-minute warm-up and a 3-minute cool-down, for a total duration of 34 minutes. Exercise is performed three times per week for eight weeks. Resistance training includes chest press, leg extension, leg press, and abdominal exercises using pneumatic resistance machines (HUR, Finland), consisting of two sets of 20-25 repetitions at approximately 20RM. Nutritional counseling is provided by a registered dietitian once every four weeks for a total of two sessions during the intervention period.
Receives: Behavioral: Low-Intensity Continuous Training (LICT)
Usual Care (Control)No interventionParticipants will receive usual postoperative care without structured exercise intervention. Nutritional counseling is provided by a registered dietitian once every four weeks for a total of two sessions during the study period.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Peak oxygen uptake (VO₂peak)

    Cardiorespiratory fitness will be assessed using symptom-limited cardiopulmonary exercise testing (CPET) on a cycle ergometer under medical supervision with continuous breath-by-breath gas analysis. After a 4-minute unloaded warm-up, workload is increased by 10-20 W/min depending on patient condition, with participants cycling at 50 rpm until volitional exhaustion. The test is terminated when cadence falls below 40 rpm, at physician discretion, or at patient exhaustion, followed by a 2-minute cool-down at 20 W. Continuous 12-lead ECG, blood pressure, and oxygen saturation are monitored during testing. VO₂peak is defined as the highest 30-second averaged oxygen uptake immediately prior to exhaustion. Peak workload, peak heart rate, and oxygen uptake at ventilatory threshold are also recorded.

    Measured: Baseline and 8 weeks after the intervention

Secondary outcomes (14)
  1. Handgrip strength

    Handgrip strength will be measured using a standard adjustable-handle dynamometer (InGrip, InBody Japan Inc., Tokyo, Japan). Measurements will be performed in a standing position with arms at the side. Two maximal voluntary efforts will be recorded for each hand, and the highest value will be used (kg) as the outcome measure.

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  2. Chair stand test

    Lower-limb muscle strength will be assessed using the 30-second chair stand test (CS-30). Participants will perform as many sit-to-stand repetitions as possible within 30 seconds without using their hands from a standard chair (approximately 43 cm seat height). The total number of completed stands will be recorded. Extended versions (CS-60 and CS-90) will be derived as endurance indicators.

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  3. Short Physical Performance Battery (SPPB)

    Physical performance will be assessed using the SPPB, consisting of standing balance, gait speed, and chair stand tests. Each component is scored and summed to produce a total score ranging from 0 (worst performance) to 12 (best performance).

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  4. Skeletal muscle mass

    Skeletal muscle mass will be measured using a segmental multi-frequency bioelectrical impedance analyzer (InBody770, InBody Japan Inc., Tokyo, Japan).

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  5. Physical activity (Japanese version of the International Physical Activity Questionnaire-Short Form)

    Physical activity will be assessed using the Japanese version of the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The IPAQ-SF provides an estimate of total physical activity expressed in metabolic equivalent task minutes per week (MET-min/week), calculated based on walking, moderate, and vigorous physical activities. The total score ranges from 0 to theoretically unlimited values, with higher scores indicating greater levels of physical activity.

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  6. Total exercise volume

    Total exercise volume will be calculated as the cumulative prescribed aerobic and resistance exercise over the 8-week intervention period. Aerobic exercise volume will be based on prescribed duration and intensity (HIIT or LICT protocols). Resistance training volume will be calculated by taking into account both the number of sets and repetitions performed across all prescribed exercises during the intervention period.

    Measured: During the 8-week intervention period

  7. Exercise adherence

    Exercise adherence will be defined as the proportion of completed supervised exercise sessions and compliance with the prescribed exercise protocol, expressed as a percentage.

    Measured: During the 8-week intervention period

  8. Patient-reported outcomes

    Health-related quality of life and symptoms will be assessed using the EORTC QLQ-C30. Scores for functional scales, symptom scales, and global health status will be linearly transformed to a 0-100 scale.

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  9. Blood biomarkers

    Serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), irisin, SPARC, and adrenaline will be measured.

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  10. Gut microbiome

    Gut microbiome composition will be analyzed using 16S rRNA sequencing of stool samples to assess alpha diversity, beta diversity, and taxonomic composition.

    Measured: Baseline and 8 weeks after the intervention

  11. Urinary urea nitrogen

    Urinary urea nitrogen (UUN) as an indicator of protein metabolism and nutritional status.

    Measured: Baseline, 4 weeks, and 8 weeks after the intervention

  12. Adverse events

    All adverse events will be systematically recorded throughout the study period.

    Measured: During the 8-week intervention period

  13. Pneumonia

    Pneumonia will be defined as new or progressive infiltrates on chest radiographs or CT scans, as well as meeting at least two of the following three criteria: body temperature greater than 38°C, leukopenia or leukocytosis (white blood cell count less than 4 × 10⁹/L or greater than 10 × 10⁹/L), and purulent sputum.

    Measured: During the 8-week intervention period

  14. Readmission

    Unplanned hospital readmission will be defined as any admission occurring after discharge and within the study period, extracted from medical records.

    Measured: During the 8-week intervention period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 May 2026
  2. Study start15 May 2026
  3. Primary completionNov 2029 (estimated)
  4. Study completionNov 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
171 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07561840
Sponsor's protocol ID
2025287
Status last verified
Aug 2026
First submitted
24 Apr 2026
Last updated
21 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared due to ethical considerations and the sensitive nature of clinical and biological data collected from patients with cancer.

Questions about this trial

What is this clinical trial studying?

A study testing High-Intensity Interval Training (HIIT) and Low-Intensity Continuous Training (LICT) in people with Esophageal Cancer and Gastric Cancer (Diagnosis), run by Kansai Medical University at 2 sites in Japan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 21 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Japan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Takuya Fukushima (+81-72-856-2115, fukushima.tky@kmu.ac.jp), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Peak oxygen uptake (VO₂peak) (time frame: Baseline and 8 weeks after the intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Aug 2026.

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