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Prognostic Value of 6-Min Walk Test to Predict Postoperative Cardiopulmonary Complications in Patients With Non-small Cell Lung Cancer.

Abstract：

BACKGROUND:The risk stratification value of the 6-min walk test (6MWT) to decide the feasibility of surgical resection is not well elucidated in patients with non-small cell lung cancer (NSCLC) and moderately decreased lung function. OBJECTIVE:This study aimed to determine the role of the 6MWT in predicting postoperative cardiopulmonary complications in patients with NSCLC who underwent lobectomy and had moderately decreased lung function. METHODS:The data were obtained from a prospective cohort study called Coordinate Approach to Cancer Patient's Health for Lung Cancer (CATCH-LUNG). Patients who underwent lobectomy for NSCLC were classified into two groups according to predicted postoperative pulmonary function (low-risk group or moderate-risk group); each group was then further classified into short-distance (< 400 m) or long-distance (≥ 400 m) groups according to a 6-min walk distance. The main end point of this study was the incidence of postoperative cardiopulmonary complications occurring within the first 30 postoperative days. A multivariable logistic regression model was used to compare the postoperative cardiopulmonary complications among the four groups. RESULTS:The adjusted ORs for any postoperative pulmonary complications, postoperative cardiac complications, and postoperative cardiopulmonary complications in patients with moderate-risk/short-distance relative to those with low-risk/long-distance were 10.26 (95% CI, 2.37-44.36), 5.65 (95% CI, 1.39-22.90), and 7.84 (95% CI, 2.24-27.46), respectively. However, these complications were not different between the patients with moderate-risk/long-term distance and those with low-risk/long-distance. Among patients in the moderate-risk group, those in the short-distance group had a significantly higher risk of postoperative cardiopulmonary complications compared with those in the long-distance group (adjusted OR, 4.95; 95% CI, 1.37-17.93). CONCLUSIONS:Patients with NSCLC with moderate-risk/short-distance were at greater risk of developing postoperative cardiopulmonary complications; it may be feasible, however, for patients with NSCLC and moderate-risk/long-distance to undergo lobectomy compared with those with low-risk/long-distance. Our study suggests that the 6MWT could provide additional information in identifying optimal candidates for lung resection surgery of NSCLC. TRIAL REGISTRY:ClinicalTrials.gov; No.: NCT03705546; URL: www.clinicaltrials.gov.

journal_name

Chest

journal_title

Chest

authors

Lee H,Kim HK,Kang D,Kong S,Lee JK,Lee G,Shin S,Cho J,Zo JI,Shim YM,Park HY

doi

10.1016/j.chest.2019.12.039

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

1665-1673

issue

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(20)30131-8

journal_volume

157

pub_type

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Prognostic Value of 6-Min Walk Test to Predict Postoperative Cardiopulmonary Complications in Patients With Non-small Cell Lung Cancer.