Taro Okayama1, Tateaki Naito2, Yusuke Yonenaga1, Takuya Ohashi3, Midori Kitagawa1, Noriko Mitsuhashi1, Takeshi Ishi1, Hiroshi Fuseya1, Takashi Aoyama4, Akifumi Notsu5, Keita Mori5, Nobuaki Mamesaya6, Takahisa Kawamura6, Haruki Kobayashi6, Shota Omori6, Kazushige Wakuda6, Akira Ono6, Hirotsugu Kenmotsu6, Haruyasu Murakami6, Akira Tanuma7, Toshiaki Takahashi6. 1. Division of Rehabilitation Medicine, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. 2. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. t.naito@scchr.jp. 3. Department of Physical Medicine and Rehabilitation, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-ku, Shizuoka City, 420-8527, Japan. 4. Division of Nutrition, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. 5. Clinical Research Center, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. 6. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. 7. Department of Rehabilitation Medicine, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2295, Japan.
Abstract
PURPOSE: Little is known about the impact of decreased walking capacity on clinical outcomes in elderly patients with cancer. This prospective observational study aimed to investigate the impact of walking capacity on the risk of disability and hospitalization in elderly patients with advanced lung cancer. METHOD: This study prospectively enrolled 60 patients aged ≥ 70 years with advanced non-small-cell lung cancer (NSCLC) scheduled to receive first-line chemotherapy or radical radiotherapy between January 2013 and December 2014 (trial registration number: UMIN000009768). Patients were classified into the mobile or less mobile group based on the median incremental shuttle walking distance (ISWD) before initial treatment. Assessments included the Barthel index, disability-free survival time, mean cumulative lengths of hospital stay, and inpatient medical costs. RESULTS: The median ISWD was 290 m (interquartile range, 245-357.5 m). The mobile group (ISWD ≥ 290 m) had a longer disability-free survival time than the less mobile group (ISWD < 290 m, 24.6 months vs. 8.4 months, p < 0.05). During the first year from study entry, the mobile group had shorter cumulative lengths of hospital stay (41.3 vs. 72.9 days/person, p < 0.05) and lower inpatient medical costs (¥1.9 vs. ¥2.9 million/person, p < 0.05) than the less mobile group. CONCLUSION: Elderly NSCLC patients with adequate walking capacity showed lower risks of disability, shorter hospitalizations, and lower inpatient medical costs than patients with reduced walking capacity. Further prospective research is needed to validate these findings. The trial was registered with the University Hospital Medical Information Network as trial number UMIN000009768 on January 13, 2013. TRIAL REGISTRATION: UMIN000009768.
PURPOSE: Little is known about the impact of decreased walking capacity on clinical outcomes in elderly patients with cancer. This prospective observational study aimed to investigate the impact of walking capacity on the risk of disability and hospitalization in elderly patients with advanced lung cancer. METHOD: This study prospectively enrolled 60 patients aged ≥ 70 years with advanced non-small-cell lung cancer (NSCLC) scheduled to receive first-line chemotherapy or radical radiotherapy between January 2013 and December 2014 (trial registration number: UMIN000009768). Patients were classified into the mobile or less mobile group based on the median incremental shuttle walking distance (ISWD) before initial treatment. Assessments included the Barthel index, disability-free survival time, mean cumulative lengths of hospital stay, and inpatient medical costs. RESULTS: The median ISWD was 290 m (interquartile range, 245-357.5 m). The mobile group (ISWD ≥ 290 m) had a longer disability-free survival time than the less mobile group (ISWD < 290 m, 24.6 months vs. 8.4 months, p < 0.05). During the first year from study entry, the mobile group had shorter cumulative lengths of hospital stay (41.3 vs. 72.9 days/person, p < 0.05) and lower inpatient medical costs (¥1.9 vs. ¥2.9 million/person, p < 0.05) than the less mobile group. CONCLUSION: Elderly NSCLC patients with adequate walking capacity showed lower risks of disability, shorter hospitalizations, and lower inpatient medical costs than patients with reduced walking capacity. Further prospective research is needed to validate these findings. The trial was registered with the University Hospital Medical Information Network as trial number UMIN000009768 on January 13, 2013. TRIAL REGISTRATION: UMIN000009768.
Entities:
Keywords:
Disability; Elderly; Incremental shuttle walking distance; Length of hospital stay; Medical cost; Non-small-cell lung cancer
Authors: Lee W Jones; 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 Journal: Lung Cancer Date: 2011-11-22 Impact factor: 5.705
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