Accelerometry-derived Moderate-to-vigorous Physical Activity Predicts Overall Survival In Patients With Cancer In The Pleural Space.

Cancer in the pleural space or malignant pleural effusion (MPE) is an incurable disease with high symptom burden of debilitating fatigue and breathlessness. Due to heterogeneity of disease and clinical factors, predicting survival outcomes in MPE is complex and often inaccurate. PURPOSE: To investigate the association of accelerometry-derived moderate-to-vigorous physical activity (MVPA) with 3-year overall survival (OS) in patients with MPE. METHODS: This is a pooled analysis of 5 studies in patients with MPE. MVPA was measured using Actigraph GT3X+ (7-day wear protocol). Medical, demographic and survival information were collected from medical records. Participants were divided into high (n = 81, median of 13.1 [interquartile range (IQR): 8.5; 30.2] min/day) and low MVPA (n = 81, median of 1.4 [IQR: 0.3; 3.0] min/day) based on median values. Cox regression analysis (hazard ratio [HR] and 95% confidence intervals [CI]) and Kaplan-Meier method were undertaken to explore the association of MVPA with 3-year OS. RESULTS: A total of 163/222 MPE patients (mean age: 67.1 ± 10.0 years) were included. The majority were male (66%) with a diagnosis of mesothelioma (58%). With 57 and 72 deaths in the high and low MVPA group, respectively, an unadjusted HR of 0.46 (95%CI: 0.32-0.65, p < 0.001) was observed for the high MVPA group. Median 3-year OS for the high MVPA group was 20.4 (95%CI: 15.8-23.3) months vs. 9.7 (95%CI: 6.4-12.3) months in low MVPA (Figure 1; p < 0.001). An adjusted HR of 0.57 (95%CI: 0.35-0.95, p < 0.05) was observed for patients with higher MVPA after controlling for Eastern Cooperative Oncology Group status (0-3), age, sex, cancer type, serum albumin, enrolled trial, waking wear time, sedentary and light physical activity time. CONCLUSION: Accelerometry-derived MVPA is a meaningful prognostic marker and could be an important target for future interventions in patients with MPE.Figure 1.: Kaplan-Meier 3-year overall survival curve stratified by low and high MVPA.