RT Journal Article SR Electronic T1 Association of performance at stair-climbing test with complications and survival after lung cancer resection in the VATS era: population-based outcomes JF ERJ Open Research JO erjor FD European Respiratory Society SP 00110-2021 DO 10.1183/23120541.00110-2021 A1 Olli Helminen A1 Johanna Valo A1 Heidi Andersen A1 Johan Söderström A1 Eero Sihvo YR 2021 UL http://openres.ersjournals.com/content/early/2021/04/29/23120541.00110-2021.abstract AB Introduction With a population-based cohort in the VATS era, we aimed to evaluate the value of stair-climbing test (SCT) on short- and long-term outcomes of lung cancer surgery.Methods All patients operated due to primary lung cancer in Central Finland and Ostrobothnia from 2013 to June 2020 were included. For the analysis, clinical variables including the outcome of SCT and cause-specific mortality were available. Short- and long-term outcomes were compared between <11 m (n=66) and >12 m SCT (n=217) groups.Results Patients with poor performance (<11 m) had more comorbidities and worse lung function but did not differ in tumor stage or treatment. No differences between groups were observed in major morbidity rate (10.6% versus 11.1%, p=0.918) or median hospital stay (5 (IQR 4–7) versus 4 (IQR 3–7), p=0.179). At 1-year, fewer patients were alive and living at home in <11 m group (81.3%) compared to >12 m group (94.2%), p=0.002. No difference was observed in cancer-specific 5-year survival. Non-cancer-specific survival (62.9% versus 83.1%, p<0.001) and overall survival (49.9% versus 70.0%, p<0.001) were worse in <11 m group. After adjustment for confounding factors, SCT remained as a significant predictor for non-cancer-specific (4.28; 95%CI 2.10 to 8.73) and overall mortality (2.38; 95%CI 1.43 to 3.98).Conclusions With SCT-based exercise testing, VATS can be performed safely, with similar major morbidity rate in poor performance group (<11 m) compared to >12 m group. Poor exercise performance increases non-cancer-specific mortality. Being a major predictor of survival, exercise capacity should be included in prognostic models.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Helminen has nothing to disclose.Conflict of interest: Dr. Valo has nothing to disclose.Conflict of interest: Dr. Andersen has nothing to disclose.Conflict of interest: Dr. Söderström has nothing to disclose.Conflict of interest: Dr. Sihvo has nothing to disclose.