Quality of life after preoperative home-based exercise training in patients with lung cancer: a secondary analysis

Background: A preoperative home-based exercise training (PHET) program appeared to improve health-related quality of life (HRQoL) in patients undergoing lung cancer surgery. However, inter-individual variability in response was observed. This secondary analysis aimed to identify characteristics of responders/non-responders to PHET, determine predictors of response, and examine whether preoperative HRQoL response to PHET is associated with postoperative HRQoL maintenance. Methods: This was a secondary analysis of pooled data from a feasibility study and a randomized controlled trial, including sociodemographic/clinical data, physical performance and HRQoL (EORTC-QLQ-C30). Responders/non-responders were classified based on a change of ≥5 points in Global QoL score (EORTC QLQ-C30) from baseline to pre-surgery time point. Between-group differences and predictors of PHET response (logistic regression) were analysed. Results: 32 patients (63% male, 67.1±7.8 years) were included, from which 56% (n=18) were responders to PHET in Global QoL. Responders had lower baseline scores in Global QoL, Emotional Function and Summary Score compared to non-responders (P<0.05), and 50% of responders had chronic obstructive pulmonary disease (COPD) (P=0.02). No other between-group differences were found (P>0.05). In the regression model including the Summary Score (EORTC-QLQ-C30) and COPD (Nagelkerke R2=0.511), COPD was a significant predictor of response: COPD patients were 13.4 times more likely to be responders (odds ratio =13.4; 95% confidence interval: 1.4; 132.2). 65% of PHET-responders maintained/improved HRQoL 1-month post-surgery. Conclusions: Most patients awaiting lung cancer surgery responded in HRQoL to a PHET, however, a considerable proportion did not. Further research is needed to identify characteristics of non-responders and optimize prehabilitation strategies accordingly.

Descrição

Article nr 209
Acknowledgments: This work was previously presented in abstract format at the European Respiratory Society International Congress 2024 (see: https://publications.ersnet.org/content/erj/64/suppl68/pa594).

Palavras-chave

Health-related quality of life (HRQoL) Lung cancer Prehabilitation

URI

http://hdl.handle.net/10400.8/16789

Citação

Pimenta S, Machado P, Silva CG, Garcia AL, Nogueira T, Silva S, dos Santos CL, Martins MV, Canha A, Oliveiros B, Martins RA, Cruz J. Quality of life after preoperative home-based exercise training in patients with lung cancer: a secondary analysis. J Thorac Dis 2026;18(3):209. doi: 10.21037/jtd-2025-1444