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. 2012 May;76(2):248-52.
doi: 10.1016/j.lungcan.2011.10.009. Epub 2011 Nov 22.

Prognostic significance of functional capacity and exercise behavior in patients with metastatic non-small cell lung cancer

Lee W Jones  1 , Whitney E Hornsby, Amy Goetzinger, Lindsay M Forbes, Emily L Sherrard, Morten Quist, Amy T Lane, Miranda West, Neil D Eves, Margaret Gradison, April Coan, James E Herndon, Amy P Abernethy
Affiliations

Prognostic significance of functional capacity and exercise behavior in patients with metastatic non-small cell lung cancer

Lee W Jones et al. Lung Cancer. 2012 May.

Abstract

Background: To investigate the prognostic importance of functional capacity and exercise behavior in patients with metastatic non-small cell lung cancer (NSCLC).

Patients and methods: Using a prospective design, 118 consecutive participants with histologically confirmed metastatic (inoperable) NSCLC and Eastern Cooperative Oncology group (ECOG) 0-3 completed a six-minute walk test to assess functional capacity and questionnaire that assessed self-reported exercise behavior. Cox proportional models were used to estimate the risk of all-cause mortality according to six-minute walk distance (6MWD) (<358.5m, 358.5-450 m, ≥450 m) and exercise behavior (MET-hrswk(-1)) categories with adjustment for important covariates.

Results: Median follow-up was 26.6 months; 77 deaths were reported during this period. Functional capacity was an independent predictor of survival (P(trend)=0.003) and added incremental prognostic value beyond that provided by PS plus other traditional markers of prognosis (P(trend)=0.025). Compared with patients achieving a 6MWD <358.5m, the adjusted hazard ratio (HR) for all-cause mortality was 0.61 (95% CI, 0.34-1.07) for a 6MWD of 358.5-450 m, and 0.48 (95% CI, 0.24-0.93) for a 6MWD >450 m. In unadjusted analysis, there was a borderline significant effect of exercise behavior on survival (p=0.052). Median survival was 12.89 months (95% CI, 9.11-21.05 months) for those reporting <9MET-hrswk(-1) compared with 25.63 months (95% CI, 11.28 to ∞ months) for those reporting ≥9MET-hrswk(-1).

Conclusions: Functional capacity is a strong independent predictor of survival in advanced NSCLC that adds to the prediction of survival beyond traditional risk factors. This parameter may improve risk stratification and prognostication in NSCLC.

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Figures

Fig. 1
Fig. 1
Association between six-minute walk distance and survival.
Fig. 2
Fig. 2
Association between exercise behavior [MET-hrs wk−1(<9 MET-hrs wk−1 vs. >9 MET-hrs wk−1)] and survival.
See this image and copyright information in PMC

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