AIMS: The prognostic importance of post-diagnosis assessment of cardiorespiratory fitness (CRF) in cancer patients is not well established. We sought to

 

Abstract

AIMS: The prognostic importance of post-diagnosis assessment of cardiorespiratory fitness (CRF) in cancer patients is not well established. We sought to examine the association between CRF and mortality in cancer patients.

METHODS AND RESULTS: This was a single-center cohort analysis of 1,632 patients (58% male; 64±12 years) with adult onset cancer who were clinically referred for exercise treadmill testing a median of 7 (IQR: 3, 12) years after primary diagnosis. CRF was defined as peak metabolic equivalents (METs) achieved during standard Bruce protocol, and categorized by tertiles. The association between CRF and all-cause and cause-specific mortality was assessed using multivariable Cox proportional hazard models adjusting for important covariates.

RESULTS: Median follow-up was 4.6 (IQR: 2.6, 7.0) years; a total of 411 deaths (229, 50, and 132 all-cause, cardiovascular, and cancer related, respectively) occurred during this period. Compared with low CRF (range: 1.9-7.6 METs), the adjusted hazard ratio (HR) for all-cause mortality was 0.38 (95% CI: 0.28-0.52) for intermediate CRF (range: 7.7-10.6 METs) and 0.17 (95% CI: 0.11-0.27) for high CRF (range: 10.7-22.0 METs). The corresponding HRs were 0.40 (95% CI: 0.19-0.86) and 0.41 (95% CI: 0.16-1.05) for cardiovascular mortality and 0.40 (95% CI: 0.26-0.60) and 0.16 (95% CI: 0.09-0.28) for cancer mortality, respectively. The adjusted risk of all-cause, cardiovascular, and cancer mortality decreased by 26%, 14%, and 25% with each 1 MET increment in CRF.

CONCLUSION: CRF is a strong, independent predictor of all-cause, cardiovascular, and cancer mortality, even after adjustment for important clinical covariates in patients with certain cancers.

PMID: 32167560 [PubMed - as supplied by publisher]

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