Quality of life after Preoperative Home-based Exercise Training in patients with Lung Cancer: a Responder Analysis

A preoperative home-based exercise training (PHET) program was effective in improving health-related quality of life (HRQoL) in patients awaiting lung cancer surgery (Machado et al., Ann Surg Oncol 2023(31), 847-59), yet response variability was observed. This secondary analysis aims to explore characteristics of responders/non-responders(R/NR) and predictors of response in HRQoL to PHET. Data from a feasibility study and an RCT were analysed and included sociodemographic/clinical data (comorbidities; Incremental Shuttle Walk test; 5 times sit-to-stand; handgrip strength), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30(EORTC-QLQ-C30). R/NR were classified using the minimal important difference (5 points) in Global HRQoL EORTC-QLQ-C30 after PHET(1-5 days before surgery). Between-group differences were analysed through independent samples t-tests, Mann–Whitney U tests, Chi-square/Fisher exact tests depending on data type/distribution. Predictors of response to PHET were analysed through a logistic regression. 32 patients (63% male, 67±8yrs) were included, 56% (n=18) R to PHET in Global QoL. R had lower Global QoL, Emotional Function and Summary Score (p<.05) and 50% had COPD (p=.019). No significant differences were found in performance variables (p>.05). In a regression model including the summary score and COPD (Nagelkerke R²=0.511), COPD was the only significant predictor: COPD patients were 13.4 times more likely to be R (OR=13.4; 95% CI 1.37; 132.17). Findings suggest that having COPD predicts response to PHET in HRQoL. Other response predictors should be investigated in larger samples.