Prognostic value of preoperative exercise capacity in patients undergoing thoracoscopic lobectomy for non-small cell lung cancer

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 128; pp. 47 - 52
• Main Authors: Hamada, Kazumi, Irie, Masataka, Fujino, Yoshihisa, Hyodo, Masahiro, Hanagiri, Takeshi
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.02.2019
• Subjects: 6-min walk distance; Aged; Carcinoma, Non-Small-Cell Lung - epidemiology; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - surgery; Comorbidity; Exercise; Exercise capacity; Female; Humans; Kaplan-Meier Estimate; Lung Neoplasms - epidemiology; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Male; Middle Aged; Non-small cell lung cancer; Overall survival; Pneumonectomy - methods; Preoperative Period; Prognosis; Proportional Hazards Models; Prospective Studies; Thoracoscopic lobectomy; Treatment Outcome; Thoracoscopic lobectomy; Overall survival; Exercise capacity; 6-min walk distance; Non-small cell lung cancer
• ISSN: 0169-5002; 1872-8332; 1872-8332
• DOI: 10.1016/j.lungcan.2018.12.013

•The 6MWD was associated with the 5-year survival rates in patients with NSCLC.•After adjustment for confounding factors, this relationship remained significant.•The 6MWT provides additional prognostic information for surgical patients with NSCLC. Whether or not the preoperative exercise capacity, as assessed by 6-min walk test, influences the survival of patients undergoing thoracoscopic lobectomy for lung cancer is unclear. We therefore investigated the prognostic value of the 6-min walk distance in this population. This prospective cohort study was conducted between 2005 and 2013. We studied 224 consecutive subjects with stage I-II non-small cell lung cancer who underwent thoracoscopic lobectomy. Survival was calculated by the Kaplan-Meier method. The log-rank test was used to assess the survival rate. Cox proportional hazards models were used to estimate the risk of 5-year all-cause mortality based on the preoperative 6-min walk distance with adjustment for other prognostic factors, including the age, performance status, postoperative cardiopulmonary complication, and pathological stage. The median follow-up period was 60.8 months. During this period, 38 deaths were recorded. The 5-year overall survival rate of the subjects with a preoperative 6-min walk distance of <400 m were significantly lower than those with a 6-min walk distance of ≥400 m (65.3% vs. 88.0%; p < 0.001). A multivariate analysis showed that the 6-min walk distance was significantly associated with the overall survival after adjusting for the age and pathologic stage (hazard ratio, 2.40; 95% confidence interval, 1.20–4.79), but it did not provide additional prognostic value beyond the performance status. The preoperative 6-min walk distance may be useful as an additional prognostic factor for patients at an increased risk of mortality after thoracoscopic lobectomy for stage I-II non-small cell lung cancer.