Association between physical functioning assessed by questionnaires and 6-minute walk distance with prognosis among patients after lung cancer surgery
OBJECTIVE: This study aimed to investigate whether subjective (EORTC QLQ C-30 Physical Functioning [PF]) and objective (6-minute walk distance [6MWD]) physical function measures are associated with prognosis in patients after lung cancer surgery.METHODS: A total of 237 postoperative lung cancer pati...
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| Published in | Journal of respiratory physical therapy Vol. 4; no. 1; pp. 32 - 38 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Respiratory Physical Therapy
21.03.2025
一般社団法人 日本呼吸理学療法学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2436-7966 |
| DOI | 10.51116/kokyurigakuryohogaku.4.1_32 |
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| Abstract | OBJECTIVE: This study aimed to investigate whether subjective (EORTC QLQ C-30 Physical Functioning [PF]) and objective (6-minute walk distance [6MWD]) physical function measures are associated with prognosis in patients after lung cancer surgery.METHODS: A total of 237 postoperative lung cancer patients were included. Physical function was assessed using 6MWD and the PF subscale score, both measured preoperatively and at discharge. Patients were categorized into groups based on the median values of 6MWD and PF. Kaplan-Meier and Cox regression analyses were used to evaluate their associations with all-cause mortality.RESULTS: The median patient age was 70 years, and 159 patients (67.1%) were male. The median (interquartile range) values of 6MWD and PF were 400 (335-450) m and 86.7 (73.3-93.3), respectively. The median follow-up period was 1396 (1103-1828) days, during which 35 patients (14.8%) died. Kaplan-Meier analysis revealed a significantly lower mortality rate in the high 6MWD group (P < 0.001), whereas PF was not significantly associated with mortality. Multivariate Cox regression analysis indicated that a higher 6MWD was associated with lower all-cause mortality (hazard ratio, 0.30; 95% confidence interval, 0.13-0.73; P < 0.001), whereas a higher PF score was not.CONCLUSION: Among postoperative lung cancer patients, 6MWD measured at discharge was a significant predictor of survival, whereas the PF score was not associated with prognosis. |
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| AbstractList | OBJECTIVE: This study aimed to investigate whether subjective (EORTC QLQ C-30 Physical Functioning [PF]) and objective (6-minute walk distance [6MWD]) physical function measures are associated with prognosis in patients after lung cancer surgery.METHODS: A total of 237 postoperative lung cancer patients were included. Physical function was assessed using 6MWD and the PF subscale score, both measured preoperatively and at discharge. Patients were categorized into groups based on the median values of 6MWD and PF. Kaplan-Meier and Cox regression analyses were used to evaluate their associations with all-cause mortality.RESULTS: The median patient age was 70 years, and 159 patients (67.1%) were male. The median (interquartile range) values of 6MWD and PF were 400 (335-450) m and 86.7 (73.3-93.3), respectively. The median follow-up period was 1396 (1103-1828) days, during which 35 patients (14.8%) died. Kaplan-Meier analysis revealed a significantly lower mortality rate in the high 6MWD group (P < 0.001), whereas PF was not significantly associated with mortality. Multivariate Cox regression analysis indicated that a higher 6MWD was associated with lower all-cause mortality (hazard ratio, 0.30; 95% confidence interval, 0.13-0.73; P < 0.001), whereas a higher PF score was not.CONCLUSION: Among postoperative lung cancer patients, 6MWD measured at discharge was a significant predictor of survival, whereas the PF score was not associated with prognosis. OBJECTIVE: This study aimed to investigate whether subjective (EORTC QLQ C-30 Physical Functioning [PF]) and objective (6-minute walk distance [6MWD]) physical function measures are associated with prognosis in patients after lung cancer surgery.METHODS: A total of 237 postoperative lung cancer patients were included. Physical function was assessed using 6MWD and the PF subscale score, both measured preoperatively and at discharge. Patients were categorized into groups based on the median values of 6MWD and PF. Kaplan-Meier and Cox regression analyses were used to evaluate their associations with all-cause mortality.RESULTS: The median patient age was 70 years, and 159 patients (67.1%) were male. The median (interquartile range) values of 6MWD and PF were 400 (335-450) m and 86.7 (73.3-93.3), respectively. The median follow-up period was 1396 (1103-1828) days, during which 35 patients (14.8%) died. Kaplan-Meier analysis revealed a significantly lower mortality rate in the high 6MWD group (P < 0.001), whereas PF was not significantly associated with mortality. Multivariate Cox regression analysis indicated that a higher 6MWD was associated with lower all-cause mortality (hazard ratio, 0.30; 95% confidence interval, 0.13-0.73; P < 0.001), whereas a higher PF score was not.CONCLUSION: Among postoperative lung cancer patients, 6MWD measured at discharge was a significant predictor of survival, whereas the PF score was not associated with prognosis. 目的：肺癌術後患者において退院時に同時測定した主観的（EORTC QLQ C-30 Physical function：PF）および，客観的（6分間歩行距離：6MWD）な身体機能が同様に生命予後と関連するか調査すること。方法：237名の肺癌術後患者を対象とした。術前，退院時の6MWDおよびPFを調査した。退院時の6MWDとPFを中央値で2群に分けKaplan-Meier解析とCOX回帰分析を適用し全死亡との関連を評価した。結果：男性が159名（67.1％），年齢の中央値は70歳であった。退院時の6MWDとPFの中央値（四分位範囲）は400（335-450）m，86.7（73.3-93.3）点であった。追跡期間は1396（1103-1828）日で，35名（14.8％）が死亡した。Kaplan-Meier解析で6MWD高値群は有意に死亡率が低かった（P<0.001）がPFは関連しなかった。多変量COX回帰分析において6MWD高値群はHR：0.30（95％CI：0.13-0.73, P<0.001）であったがPFは関連しなかった。結論：肺癌術後患者において退院時に取得した6MWDは生存予測と関連があったがPFの関連は認めなかった。 |
| Author | 杉村 裕志 宮越 浩一 太田 幸將 齋藤 洋 |
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| References | 4) Agarwala P, Salzman SH, Six-Minute Walk Test: Clinical Role, Technique, Coding, and Reimbursement. Chest 157: 603-611, 2020. 15) Stokke K, Halvorsen T O, Grønberg B H, et al.: Associations between Measured and Patient-Reported Physical Function and Survival in Advanced NSCLC. Healthcare (Basel) 10: 2022. 6) Möller A, Sartipy U, Associations between Changes in Quality of Life and Survival after Lung Cancer Surgery. J. Thorac. Oncol. Off. Publ. Int. Assoc. Study Lung Cancer 7: 183-187, 2012. 3) Hamada K, Irie M, Fujino Y, et al.: Prognostic Value of Preoperative Exercise Capacity in Patients Undergoing Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer. Lung Cancer Amst. Neth 128: 47-52, 2019. 5) Fukushima T, Suzuki K, Tanaka T, et al.: Global quality of life and mortality risk in patients with cancer: a systematic review and meta-analysis. Qual Life Res 29: 2024. 9) ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS Statement: Guidelines for the Six-Minute Walk Test. Am. J. Respir. Crit. Care Med 166: 111-117, 2002. 13) Tanaka S, Ozeki N, Mizuno Y, et al.: Preoperative Paraspinous Muscle Sarcopenia and Physical Performance as Prognostic Indicators in Non-Small-Cell Lung Cancer. J. Cachexia Sarcopenia Muscle 12: 646-656, 2021. 7) Saito H, Shiraishi A, Nomori H, et al.: Impact of Age on the Recovery of Six-Minute Walking Distance after Lung Cancer Surgery: A Retrospective Cohort Study. Gen. Thorac. Cardiovasc. Surg 68: 150-157, 2020. 8) Nagamatsu Y, Maeshiro K, Kimura N, et al.: Long-term recovery of exercise capacity and pulmonary function after lobectomy. J Thorac Cardiovasc Surg 134: 1273-8, 2007. 14) Braun D P, Gupta D, Staren E D.: Quality of Life Assessment as a Predictor of Survival in Non-Small Cell Lung Cancer. BMC Cancer 11: 2011. https://doi.org/10.1186/1471-2407-11-353. 12) Kasymjanova G, Correa JA, Kreisman H, et al.: Prognostic value of the six-minute walk in advanced non-small cell lung cancer. J Thorac Oncol 4: 602-7, 2009. 16) Kristensen A, Grønberg B H, Fløtten Ø, et al.: Trajectory of Health-Related Quality of Life during the Last Year of Life in Patients with Advanced Non-Small-Cell Lung Cancer. Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer 30: 9351-9358, 2022. 11) Irie M, Nakanishi R, Yasuda M, et al.: Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer. Eur Respir J 48: 495-503, 2016. 2) Marjanski T, Badocha M, Wnuk D, et al.: Result of the 6-Min Walk Test Is an Independent Prognostic Factor of Surgically Treated Non-Small-Cell Lung Cancer. Interact. Cardiovasc. Thorac. Surg 28: 368-374, 2019. 10) Fayers PM, Aaronson NK, Bjordal K, et al.: EORTC QLQ-C30 Scoring Manual. Third edition. EORTC Quality of Life Group. Brussels. 7-15, 2001. 1) Granger CL, McDonald CF, Parry SM, et al.: Functional Capacity, Physical Activity and Muscle Strength Assessment of Individuals with Non-Small Cell Lung Cancer: A Systematic Review of Instruments and Their Measurement Properties. BMC Cancer 13: 2013. |
| References_xml | – reference: 10) Fayers PM, Aaronson NK, Bjordal K, et al.: EORTC QLQ-C30 Scoring Manual. Third edition. EORTC Quality of Life Group. Brussels. 7-15, 2001. – reference: 6) Möller A, Sartipy U, Associations between Changes in Quality of Life and Survival after Lung Cancer Surgery. J. Thorac. Oncol. Off. Publ. Int. Assoc. Study Lung Cancer 7: 183-187, 2012. – reference: 3) Hamada K, Irie M, Fujino Y, et al.: Prognostic Value of Preoperative Exercise Capacity in Patients Undergoing Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer. Lung Cancer Amst. Neth 128: 47-52, 2019. – reference: 8) Nagamatsu Y, Maeshiro K, Kimura N, et al.: Long-term recovery of exercise capacity and pulmonary function after lobectomy. J Thorac Cardiovasc Surg 134: 1273-8, 2007. – reference: 15) Stokke K, Halvorsen T O, Grønberg B H, et al.: Associations between Measured and Patient-Reported Physical Function and Survival in Advanced NSCLC. Healthcare (Basel) 10: 2022. – reference: 4) Agarwala P, Salzman SH, Six-Minute Walk Test: Clinical Role, Technique, Coding, and Reimbursement. Chest 157: 603-611, 2020. – reference: 16) Kristensen A, Grønberg B H, Fløtten Ø, et al.: Trajectory of Health-Related Quality of Life during the Last Year of Life in Patients with Advanced Non-Small-Cell Lung Cancer. Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer 30: 9351-9358, 2022. – reference: 1) Granger CL, McDonald CF, Parry SM, et al.: Functional Capacity, Physical Activity and Muscle Strength Assessment of Individuals with Non-Small Cell Lung Cancer: A Systematic Review of Instruments and Their Measurement Properties. BMC Cancer 13: 2013. – reference: 14) Braun D P, Gupta D, Staren E D.: Quality of Life Assessment as a Predictor of Survival in Non-Small Cell Lung Cancer. BMC Cancer 11: 2011. https://doi.org/10.1186/1471-2407-11-353. – reference: 12) Kasymjanova G, Correa JA, Kreisman H, et al.: Prognostic value of the six-minute walk in advanced non-small cell lung cancer. J Thorac Oncol 4: 602-7, 2009. – reference: 13) Tanaka S, Ozeki N, Mizuno Y, et al.: Preoperative Paraspinous Muscle Sarcopenia and Physical Performance as Prognostic Indicators in Non-Small-Cell Lung Cancer. J. Cachexia Sarcopenia Muscle 12: 646-656, 2021. – reference: 5) Fukushima T, Suzuki K, Tanaka T, et al.: Global quality of life and mortality risk in patients with cancer: a systematic review and meta-analysis. Qual Life Res 29: 2024. – reference: 7) Saito H, Shiraishi A, Nomori H, et al.: Impact of Age on the Recovery of Six-Minute Walking Distance after Lung Cancer Surgery: A Retrospective Cohort Study. Gen. Thorac. Cardiovasc. Surg 68: 150-157, 2020. – reference: 9) ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS Statement: Guidelines for the Six-Minute Walk Test. Am. J. Respir. Crit. Care Med 166: 111-117, 2002. – reference: 2) Marjanski T, Badocha M, Wnuk D, et al.: Result of the 6-Min Walk Test Is an Independent Prognostic Factor of Surgically Treated Non-Small-Cell Lung Cancer. Interact. Cardiovasc. Thorac. Surg 28: 368-374, 2019. – reference: 11) Irie M, Nakanishi R, Yasuda M, et al.: Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer. Eur Respir J 48: 495-503, 2016. |
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| SubjectTerms | 6分間歩行試験 EORTC QLQ C-30 予後 手術 肺癌 |
| Title | Association between physical functioning assessed by questionnaires and 6-minute walk distance with prognosis among patients after lung cancer surgery |
| URI | https://www.jstage.jst.go.jp/article/kokyurigakuryohogaku/4/1/4_32/_article/-char/en https://cir.nii.ac.jp/crid/1390022023424043264 |
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