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Laerke Winther
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P2.10 - Nursing/Palliative Care/Ethics (ID 711)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.10-003 - The Deterioration and Prognostic Value of Functional Capacity in Patients with Lung Cancer: A Systematic Review (ID 8769)
09:30 - 09:30 | Presenting Author(s): Laerke Winther
- Abstract
Background:
Performance status (PS) scoring systems are of immense prognostic and clinical importance, however, the subjective evaluation of a patient’s global physical functioning is limited in sensitive prognostic stratification and existing literature present contradictory inter-rater reliability of PS assessments. The subjective assessment indicates the level of physical functioning, but does not provide a targeted treatment aim. Better treatment aims could be provided, if the level of decline in physical functioning was objectively collected and evaluated. To our knowledge, the significance of functional capacity in patients with lung cancer has never been evaluated prior to this review. Thus, the aim of this study was to identify and evaluate the evidence objectively examining 1) the decline in functional capacity in patients with lung cancer during cancer treatment, and 2) the prognostic value of functional capacity for patients with lung cancer.
Method:
The systematic review was reported according to PRISMA guidelines. A search in three databases: PubMed, EMBASE and Web of Science, generated 171 articles. Quantitative study designs, including case-series and case-controls, assessing functional capacity in patients with lung cancer were included. Self-reported functional capacity was excluded. No restrictions on publication date were imposed. Only articles published in English were considered for inclusion.
Result:
Eight studies on a total of 908 patients with lung cancer met the inclusion criteria. The majority of the studies were prospective cross-sectional studies (n=7), remaining was a case-control (n=1). Patients with lung cancer had already declined in functional capacity at baseline compared to healthy adults, and deteriorated further during initial cancer treatment. Functional capacity as a predictive measure was not associated with radiation induced lung injury. A 6-minute walking distance (6MWD) >400 m was associated with a 56 % reduction in the risk of death, and every 50 m improvement in 6MWD was associated with a 13 % risk reduction.
Conclusion:
The results of this review demonstrate that functional capacity (6MWD) declines following non-surgical NSCLC treatment as well as low functional capacity being associated with higher risk of mortality. By implementing an objective measure for functional capacity at the time of diagnosis, it could be possible to generate targeted treatment aims throughout the medical treatment and rehabilitation process. In addition, an objective measure for functional capacity could provide a better prognostic stratification.
