1. Prognostic significance of preoperative exercise tolerance in patients with early-stage lung cancer.
- Author
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Fukui M, Matsunaga T, Hattori A, Takamochi K, Tomita H, Nojiri S, and Suzuki K
- Subjects
- Humans, Male, Female, Retrospective Studies, Aged, Middle Aged, Pneumonectomy adverse effects, Pneumonectomy mortality, Prognosis, Exercise Test, Risk Factors, Predictive Value of Tests, Preoperative Exercise, Lung Neoplasms surgery, Lung Neoplasms mortality, Lung Neoplasms pathology, Lung Neoplasms physiopathology, Exercise Tolerance, Neoplasm Staging
- Abstract
Objective: To investigate the influence of simple preoperative exercise tests as prognostic factors for early-stage lung cancer., Methods: This single-institution retrospective study included consecutive patients who underwent pulmonary resection for stage 0 to I lung cancer between April 2017 and December 2019. Before surgery, 7 metabolic equivalents of task in the double Master 2-step test were loaded into the exercise echocardiogram. The relationship between prognosis and exercise stress test results in terms of availability, symptoms, and saturation of percutaneous oxygen was investigated., Results: This study included 862 patients with pathological stage 0 to I lung cancer. Among the 862 patients, 673 patients (78.1%) who were able to complete 7 metabolic equivalents of task exercise for 3 minutes without assistance were classified into the complete group. The 5-year survival of the complete group was significantly better than that of the incomplete group. Multivariable analysis revealed that age (hazard ratio, 1.06; P = .008), male sex (hazard ratio, 2.23; P = .011), carcinoembryonic antigen level >5 ng/mL (hazard ratio, 2.33; P = .011), and inability to complete 7 metabolic equivalents of task exercise (hazard ratio, 3.90; P < .001) were the prognostic factors. Patients in the older group who had the ability to complete exercise had a better prognosis than those in the younger group without the ability (P = .003)., Conclusions: Preoperative exercise ability is a prognostic factor for early-stage lung cancer. Patients who can tolerate an exercise load of 7 metabolic equivalents of task, even if they are aged 70 years or older, have a better prognosis than patients younger than age 70 years without exercise tolerance., Competing Interests: Conflict of Interest Statement The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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