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Predictive Ability of the Five-time Chair Stand Test for Postoperative Pneumonia after Minimally Invasive Esophagectomy for Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The revised sarcopenia guidelines proposed handgrip strength (HGS) and five-time chair stand test (5-CST) as the primary parameters of muscle function. HGS and 5-CST are associated with pulmonary function among community-dwelling people, although few reports have described an association between these parameters and surgical outcomes in carcinomas. We examined the predictive ability of 5-CST for postoperative pneumonia after minimally invasive esophagectomy (MIE) compared with that of HGS.

Methods

This retrospective, single-center, observational study evaluated 222 male patients who underwent MIE for esophageal cancer between February 2018 and October 2020. Sarcopenia parameters included 5-CST, HGS, and skeletal muscle index. Postoperative pneumonia predictors were determined by using multivariate logistic regression analysis. We assessed the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) to analyze the predictive ability of 5-CST and HGS.

Results

MIE was performed for squamous cell carcinoma (n = 179), adenocarcinoma (n = 38), and other cancers (n = 5). Forty-nine (22.1%) patients developed postoperative pneumonia. Multivariate logistic regression showed that age (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.01–1.10; p = 0.027), 5-CST (OR, 1.19; 95% CI 1.00–1.40; p = 0.046), and recurrent laryngeal nerve palsy (RLNP) (OR, 3.37; 95% CI 1.60–7.10; p = 0.001) significantly predicted postoperative pneumonia. Category-free NRI and IDI showed that adding 5-CST in the prediction model with age and RLNP resulted in significantly greater reclassification and discrimination abilities than did HGS.

Conclusions

The 5-CST significantly predicted postoperative pneumonia after MIE. NRI and IDI analyses suggested that 5-CST had significantly better predictive ability for postoperative pneumonia than did HGS.

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Acknowledgments

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Funding

This study was not supported by any funding source.

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Authors and Affiliations

  1. Division of Esophageal Surgery, National Cancer Center Hospital, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Daisuke Kurita MD, Toru Sakurai MD, Daichi Utsunomiya MD, Kentaro Kubo MD, Yusuke Fujii MD, Kyohei Kanematsu MD, Koshiro Ishiyama MD, PhD, Junya Oguma MD, PhD & Hiroyuki Daiko MD, PhD, FACS

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  1. Daisuke Kurita MD
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  2. Toru Sakurai MD
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  3. Daichi Utsunomiya MD
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  4. Kentaro Kubo MD
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  5. Yusuke Fujii MD
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  6. Kyohei Kanematsu MD
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  7. Koshiro Ishiyama MD, PhD
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  8. Junya Oguma MD, PhD
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  9. Hiroyuki Daiko MD, PhD, FACS
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Correspondence to Hiroyuki Daiko MD, PhD, FACS.

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Kurita, D., Sakurai, T., Utsunomiya, D. et al. Predictive Ability of the Five-time Chair Stand Test for Postoperative Pneumonia after Minimally Invasive Esophagectomy for Esophageal Cancer. Ann Surg Oncol 29, 7462–7470 (2022). https://doi.org/10.1245/s10434-022-12002-4

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  • DOI: https://doi.org/10.1245/s10434-022-12002-4

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