{"title":"Patient-reported walking difficulty predicting the post-discharge overall function in patients with lung cancer undergoing minimally invasive surgery.","authors":"Xin Tian, Peiyang Mao, Cheng Lei, Hongfan Yu, Wei Dai, Xing Wei, Jingyu Zhang, Wei Xu, Qiuling Shi","doi":"10.1007/s11764-025-01859-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Postoperative mobility of patients with lung cancer is crucial for their physical rehabilitation. This study aimed to identify severe walking difficulty by a threshold and predicting the functional recovery of patients with lung cancer undergoing minimally invasive surgery (MIS).</p><p><strong>Methods: </strong>This prospective study enrolled patients with lung cancer who underwent MIS, divided into two cohorts. The 0-10 scale walking difficulty score was assessed regularly during hospitalization and post-discharge. Chi-square and receiver operating characteristic curve analyses guided to define the threshold, with the Timed Up and Go Test on postoperative day 2 as an anchor in cohort 1. Cohort 2 included patients assessed for walking difficulty at discharge. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was assessed biweekly for 1 month post-discharge. Post-discharge functional status trajectories were compared based on the threshold.</p><p><strong>Results: </strong>Based on cohort 1, the threshold for walking difficulty was set to 4. Cohort 2 patients were categorized using the threshold: 71.26% exhibited no or mild, while 28.74% experienced severe walking difficulty upon discharge. Compliance rates for reporting walking difficulty post-discharge consistently exceeded 60%. Walking difficulty severity significantly impacted post-discharge physical function (P < 0.001), emotional function (P = 0.008), role function (P < 0.001), and quality of life (P = 0.033).</p><p><strong>Conclusions: </strong>A patient-reported walking difficulty score of ≥ 4 indicates severe walking difficulty. Significant differences in post-discharge functional status were observed among patients with different walking difficulty degrees.</p><p><strong>Implications for cancer survivors: </strong>Continuous rehabilitation care of severe walking difficulty demonstrates significant prognostic value for post-discharge functional recovery.</p><p><strong>Trial registration: </strong></p><p><strong>Clinicaltrials: </strong>gov Identifier: ChiCTR2000033016.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Survivorship","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11764-025-01859-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Postoperative mobility of patients with lung cancer is crucial for their physical rehabilitation. This study aimed to identify severe walking difficulty by a threshold and predicting the functional recovery of patients with lung cancer undergoing minimally invasive surgery (MIS).
Methods: This prospective study enrolled patients with lung cancer who underwent MIS, divided into two cohorts. The 0-10 scale walking difficulty score was assessed regularly during hospitalization and post-discharge. Chi-square and receiver operating characteristic curve analyses guided to define the threshold, with the Timed Up and Go Test on postoperative day 2 as an anchor in cohort 1. Cohort 2 included patients assessed for walking difficulty at discharge. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was assessed biweekly for 1 month post-discharge. Post-discharge functional status trajectories were compared based on the threshold.
Results: Based on cohort 1, the threshold for walking difficulty was set to 4. Cohort 2 patients were categorized using the threshold: 71.26% exhibited no or mild, while 28.74% experienced severe walking difficulty upon discharge. Compliance rates for reporting walking difficulty post-discharge consistently exceeded 60%. Walking difficulty severity significantly impacted post-discharge physical function (P < 0.001), emotional function (P = 0.008), role function (P < 0.001), and quality of life (P = 0.033).
Conclusions: A patient-reported walking difficulty score of ≥ 4 indicates severe walking difficulty. Significant differences in post-discharge functional status were observed among patients with different walking difficulty degrees.
Implications for cancer survivors: Continuous rehabilitation care of severe walking difficulty demonstrates significant prognostic value for post-discharge functional recovery.
背景：肺癌患者术后活动能力对其身体康复至关重要。本研究旨在通过阈值识别严重行走困难，并预测肺癌微创手术（MIS）患者的功能恢复。方法：这项前瞻性研究纳入了接受MIS治疗的肺癌患者，分为两组。在住院期间和出院后定期评估0-10分制步行困难评分。卡方分析和受试者工作特征曲线分析指导定义阈值，以术后第2天的Timed Up and Go测试作为队列1的锚点。队列2包括出院时评估行走困难的患者。欧洲癌症研究和治疗组织生活质量问卷Core 30在出院后1个月内每两周进行一次评估。基于阈值比较出院后功能状态轨迹。结果：在队列1的基础上，将行走困难阈值设置为4。队列2患者使用阈值进行分类：71.26%的患者出院时无或轻度行走困难，28.74%的患者出院时出现严重行走困难。出院后报告行走困难的依从率一直超过60%。行走困难严重程度显著影响出院后的身体功能(P结论：患者报告的行走困难评分≥4分表明行走困难严重。不同行走困难程度患者出院后功能状态差异有统计学意义。对癌症幸存者的影响：严重行走困难的持续康复护理对出院后功能恢复具有重要的预后价值。试验注册：Clinicaltrials: gov标识符：ChiCTR2000033016。
期刊介绍：
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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