Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 7;33(7):554.
doi: 10.1007/s00520-025-09542-2.

Predictive relationship in perioperative symptoms and step count for lung cancer patients

Lijia Hou #  1   2 , Yang Zhao #  3 , Mingqi Zhang  1 , Xiaobo Wang  1 , Lihong Zhu  4 , Tingting Chen  1 , Xinyan Wu  1 , Danfeng Gu  5
Affiliations

Predictive relationship in perioperative symptoms and step count for lung cancer patients

Lijia Hou et al. Support Care Cancer. .

Abstract

Background: Lung cancer patients' recovery is hindered by persistent symptoms, but the relationship between symptoms and physical activity is not well understood.

Objective: The objective of this study is to examine changes in symptoms and physical activity among lung cancer patients and their short-term predictive relationship.

Methods: Ninety-six lung cancer patients (average age 59.70) were selected. Symptoms (pain, fatigue, distress, cough, dyspnea, and sleepiness) were monitored three times daily from preoperative to postoperative day 6 using the Ecological Momentary Assessment. Step count was continuously monitored via a smartwatch. Short-term trends in symptoms and step count were analyzed. A hierarchical linear model was used to examine the immediate and lagged correlations between symptoms and step count, with confounders controlled.

Results: Symptoms and step counts showed fluctuation with a jagged changing trajectory. Step count decreased significantly when symptoms were worse than the individual average (P < 0.001), except for cough. Symptoms were significantly reduced when step count significantly increased (P < 0.001). Pain (β = - 73.384, P < 0.001) had a negative predictive effect on step count at the next moment, after controlling for step count. Step count at the same time had a significant effect on alleviating pain (β = - 0.0002, P < 0.05), fatigue (β = - 0.0003, P < 0.05), and sleepiness (β = - 0.0003, P < 0.001), next moment, after controlling for symptoms. There was a significant intrinsic predictive effect between symptoms and step count (P < 0.001).

Conclusion: Lung cancer patients experience fluctuations in symptoms and step count during the perioperative period. There is a significant relationship between symptoms and step count on the same day. Future studies could explore interventions to improve symptoms and mobility.

Keywords: Ecological momentary assessments; Lung cancer; Perioperative; Physical activity; Surgical treatment.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: This study adhered to the principles outlined in the Declaration of Helsinki. The study protocol and informed consent procedure were reviewed and approved by the Ethics Committee of Wuxi Medical College, Jiangnan University (approval No. JNU20230301IRB08). Consent to participate: All patients signed the informed consent form voluntarily after they were clearly explained and had fully understood the purposes, procedures, potential risks, and benefits of participating in this study. Competing interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660 - DOI
    1. Cao W, Chen HD, Yu YW, Li N, Chen WQ (2021) Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl) 134(7):783–791. https://doi.org/10.1097/CM9.0000000000001474 - DOI
    1. Donington J, Schumacher L, Yanagawa J (2022) Surgical issues for operable early-stage non-small-cell lung cancer. J Clin Oncol 40(6):530–538. https://doi.org/10.1200/JCO.21.01592 - DOI
    1. Bitenc M, Cufer T, Kern I, Miklavcic M, Petrovic S, Groznik V, Sadikov A (2022) Real-life long-term outcomes of upfront surgery in patients with resectable stage I-IIIA non-small cell lung cancer. Radiol Oncol 56(3):346–354. https://doi.org/10.2478/raon-2022-0030 - DOI
    1. Tang L, Yu H, Dai W, Yang X, Wei X, Wang XS, Cleeland CS, Li Q, Shi Q (2023) Symptom trajectories informing patient care after lung cancer surgery: a longitudinal patient-reported outcome study. Ann Surg Oncol 30(5):2607–2617. https://doi.org/10.1245/s10434-022-13065-z - DOI