Department of Rehabilitation Medicine, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, 1-3-1 Kanada, Kokurakita-ku, Kitakyushu, Fukuoka, 803-8505, Japan.
Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
Lung Cancer. 2019 Feb;128:47-52. doi: 10.1016/j.lungcan.2018.12.013. Epub 2018 Dec 16.
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.
术前 6 分钟步行试验评估的运动能力是否影响接受胸腔镜肺叶切除术的肺癌患者的生存情况尚不清楚。因此，我们研究了该人群中 6 分钟步行距离的预后价值。
这是一项前瞻性队列研究，于 2005 年至 2013 年进行。我们研究了 224 例连续接受胸腔镜肺叶切除术的 I 期至 II 期非小细胞肺癌患者。通过 Kaplan-Meier 法计算生存率。对数秩检验用于评估生存率。Cox 比例风险模型用于根据术前 6 分钟步行距离，在调整其他预后因素（包括年龄、体力状态、术后心肺并发症和病理分期）的情况下，估计 5 年全因死亡率的风险。
中位随访时间为 60.8 个月。在此期间，记录了 38 例死亡。术前 6 分钟步行距离<400m 的患者的 5 年总生存率明显低于 6 分钟步行距离≥400m 的患者（65.3%比 88.0%；p<0.001）。多变量分析表明，在调整年龄和病理分期后，6 分钟步行距离与总生存率显著相关（风险比，2.40；95%置信区间，1.20-4.79），但在体力状态之外，它并没有提供额外的预后价值。
术前 6 分钟步行距离可能是一种有用的预后因素，可用于预测 I 期至 II 期非小细胞肺癌患者接受胸腔镜肺叶切除术后死亡风险增加的患者。
