Factors Related to Functional Capacity Deterioration in Surgical Lung Cancer Patients: A Systematic Review.

Background: A decline in functional capacity is anticipated after lung resection. However, the factors related to functional capacity deterioration in surgical lung cancer patients have not been systematically reviewed.

Objective: To investigate the factors related to functional capacity deterioration and the trajectory of functional capacity after lung cancer surgery.

Methods: PubMed, CINAHL, Scopus, and SPORTDiscus were searched between January 2010 and July 2022. Two reviewers conducted a critical appraisal of individual sources. Twenty-one studies met the inclusion criteria.

Results: This review presents evidence for risk factors related to functional capacity deterioration after lung cancer surgery, including patient characteristics (age), preoperative clinical factors (vital capacity, quadriceps force, B-type natriuretic peptide level), surgery-related factors (surgical procedure, duration of chest tube drainage, postoperative complications), and postoperative clinical factor (C-reactive protein level). Most patients had a significant decline in functional capacity in the short term (≤1 month from surgery). In the medium term (1 to ≤6 months from surgery), although the functional capacity did not return to the preoperative level, the decline became insignificant.

Conclusions: This study is the first to review factors related to functional capacity in lung cancer patients. The findings can help clinicians to better identify patients at risk of functional capacity decline and allocate clinical resources more efficiently.

Implications for practice: The risk factors related to the functional capacity decline in surgical lung cancer patients should be evaluated routinely during perioperative nursing assessments. Preoperative and postoperative nursing interventions can potentially improve modifiable risk factors and prevent functional capacity deterioration.