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Impact of preoperative 6-minute walk distance on long-term prognosis after esophagectomy in patients with esophageal cancer

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Abstract

Background

The 6-minute walk distance (6MWD) is a simple way of assessing exercise capacity. The purpose of this study was to investigate the relationship between preoperative 6MWD and long-term prognosis after esophagectomy.

Methods

This retrospective cohort study involved 108 patients who underwent radical esophagectomy for esophageal cancer between 2013 and 2020. The patients were classified into the short group (SG: 6MWD < 480 m) or the long group (LG: 6MWD  ≥  480 m). To adjust for the background characteristics of both groups, propensity score matching (PSM) analysis was performed and 32 patients were matched from each group. Five-year overall survival (OS) and relapse-free survival (RFS) were analyzed by the Kaplan–Meier method. The log-rank test was used to evaluate differences in survival between the groups. After adjusting for other prognostic factors, the Cox proportional hazards model was used to investigate the impact of preoperative 6MWD on long-term prognosis.

Results

The median follow-up period was 923 days. Thirty-three deaths were recorded during the study period. After PSM, 5-year OS following surgery was 29.2 and 66.1% (p = 0.003) and 5-year RFS was 27.9 and 58.6% (p  =  0.021) in the SG and LG, respectively. In Cox proportional hazards analysis, the SG was a significant independent risk factor for OS (hazard ratio 3.33; 95% confidence interval 1.37–8.11, p = 0.008) and RFS (hazard ratio 2.30; 95% confidence interval 1.08–4.88, p = 0.030).

Conclusion

The preoperative 6MWD is useful for evaluating exercise capacity and predicting the long-term outcome in patients undergoing esophagectomy.

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Acknowledgements

The authors thank the staff in the rehabilitation department at Tokushima University Hospital for their assistance with data collection.

Author information

Authors and Affiliations

  1. Division of Rehabilitation, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan

    Shin Kondo

  2. Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan

    Shin Kondo, Takashi Saito & Rei Ono

  3. Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan

    Tatsuro Inoue

  4. Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3‑18‑15 Kuramoto‑cho, Tokushima, 770‑8503, Japan

    Takahiro Yoshida, Seiya Inoue, Takeshi Nishino, Masakazu Goto & Akira Tangoku

  5. Department of Rehabilitation Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan

    Nori Sato & Shinsuke Katoh

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  1. Shin Kondo
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Shin Kondo, Tatsuro Inoue, Takahiro Yoshida, and Takashi Saito. The first draft of the manuscript was written by Shin Kondo, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Shin Kondo.

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Ethical statement

All the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Supplementary Information

Below is the link to the electronic supplementary material.

10388_2021_871_MOESM1_ESM.tif

Supplementary file 1: Supplementary Fig. 1 Univariate and multivariate analyses for cancer-specific survival in all patients and propensity-matched patients. (TIF 92 KB)

10388_2021_871_MOESM2_ESM.docx

Supplementary file 2: Supplementary Table 1 Cancer-specific survival curves for patients in the SG (6MWD < 480 m) and LG (6MWD ≥ 480 m). (a) There was no significant association between preoperative 6MWD and cancer-specific survival (p = 0.057, log-rank test) in all patients. (b) There was no significant association between preoperative 6MWD and relapse-free survival (p = 0.103, log-rank test) in propensity-matched patients. 6MWD 6-minute walk distance; LG long group; SG short group; PSM, propensity score matching. (DOCX 16 KB)

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Kondo, S., Inoue, T., Yoshida, T. et al. Impact of preoperative 6-minute walk distance on long-term prognosis after esophagectomy in patients with esophageal cancer. Esophagus 19, 95–104 (2022). https://doi.org/10.1007/s10388-021-00871-9

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  • DOI: https://doi.org/10.1007/s10388-021-00871-9

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