Physical activity and prognosis and factors associated with low physical activity in patients with advanced or recurrent lung cancer: a retrospective, observational study.

OBJECTIVES: To investigate the relationship between physical activity and prognosis, and the significant factors associated with physical activity in patients with advanced or recurrent lung cancer. METHODS: This retrospective, observational study enrolled 50 outpatients with lung cancer who received chemotherapy. Patients were evaluated for physical function, physical activity (International Physical Activity Questionnaire-Short Form), and nutritional status (Mini Nutritional Assessment-Short Form [MNA-SF]). The relationship between physical activity and prognosis was examined using the log-rank test and Cox proportional hazards model. Multivariate logistic regression analysis was performed to examine factors associated with low physical activity. A receiver operating characteristic curve was used to calculate the MNA-SF cut-off value for low physical activity. RESULTS: Low physical activity was significantly associated with survival (HR, 4.35; 95% confidence interval [CI], 1.16-16.27; p=0.029). The MNA-SF was a significant factor associated with low physical activity (OR, 0.71; 95% CI, 0.52 to 0.98; p=0.038). The MNA-SF cut-off value for low physical activity was 9.5 points. CONCLUSIONS: Low physical activity may be a prognostic factor in lung cancer, with nutritional status associated with low physical activity. Regular assessments using the MNA-SF cut-off and physical activity interventions considering nutrition are needed in clinical practice.

Investigation of a practical assessment index to capture the clinical presentation of cachexia in patients with lung cancer.

OBJECTIVE: Cancer cachexia constitutes a poor prognostic factor in patients with lung cancer. However, the factors associated with cancer cachexia remain unclear. This study aimed to identify factors that influence cancer cachexia in patients with lung cancer. METHODS: In this retrospective observational study conducted at the Kansai Medical University, 76 patients with lung cancer were evaluated for physical function, nutritional status (Mini Nutritional Assessment-Short Form) and physical activity (International Physical Activity Questionnaire-Short Form) at the first visit to the rehabilitation outpatient clinic. The patients were divided into cachexia and noncachexia groups. The log-rank tests and Cox proportional hazards model were used to investigate the relationship between cachexia and prognosis. To examine the factors that influence cachexia, multivariate regression analysis with significant (P < 0.05) variables in the univariate logistic regression analysis was performed. Spearman's correlation analysis was performed to investigate the association between International Physical Activity Questionnaire-Short Form and performance status. RESULTS: Overall, 42 patients (55.2%) had cachexia associated with survival time since their first visit to the outpatient rehabilitation clinic, even after confounders adjustment (hazard ratio: 3.24, 95% confidence interval: 1.12-9.45, P = 0.031). In the multivariate analysis, Mini Nutritional Assessment-Short Form (odds ratio: 20.34, 95% confidence interval: 4.18-99.02, P < 0.001) and International Physical Activity Questionnaire-Short Form (odds ratio: 4.63, 95% confidence interval: 1.20-17.89, P = 0.026) were identified as independent factors for cachexia. There was no correlation between International Physical Activity Questionnaire-Short Form and performance status (r = 0.155, P = 0.181). CONCLUSION: Malnutrition and low physical activity were associated with cachexia in patients with lung cancer. The International Physical Activity Questionnaire-Short Form may be a useful indicator of physical activity in cachexia. Regularly assessing these factors and identifying suitable interventions for cachexia remain challenges to be addressed in the future.