The prognostic value of physical functioning on survival in patients with nonsmall cell lung cancer: a systematic review and meta-analysis.
Eva Arents, Sarah Haesevoets, Marthe Van Overbeke et al.
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In 30 seconds
This systematic review and meta-analysis examined whether objectively measured physical functioning predicts survival in adults with nonsmall cell lung cancer (NSCLC), across surgical and nonsurgical treatment groups. It included 58 studies involving 19 436 patients, with most assessments made before treatment. In nonsurgical cohorts, low functional exercise capacity was associated with higher mortality (HR 2.11); low handgrip strength and physical inactivity were also associated with higher mortality. Among surgical patients, survivors had higher exercise capacity (standardised mean difference 0.79).
Key findings
- In nonsurgical cohorts, low functional exercise capacity was associated with higher mortality (HR 2.11).
- Low handgrip strength (HR 1.27) and physical inactivity (HR 2.86) were associated with higher mortality in nonsurgical cohorts.
- In the surgical-group meta-analysis, survivors had higher exercise capacity (standardised mean difference 0.79).
- Surgical cohorts had no studies assessing physical functioning in the ICF domains of body functions and structures or participation.
Why it matters
The findings suggest that objective measures of physical functioning may add prognostic information across NSCLC treatment settings. Such measures could help characterise survival risk, although the evidence varies by treatment group and functional domain. The review also highlights gaps in surgical cohorts and the need for more consistent measurement before these indicators can be applied uniformly.
What to keep in mind
Studies showed heterogeneity and used varying thresholds. In surgical cohorts, evidence was limited to activity-based measures; body functions and participation were not evaluated.