Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting
Objectives Investigate the correlation between the percentage of predicted forced expiratory volume in 1 s (FEV1%pred) and survival outcomes, namely relapse-free survival (RFS) and overall survival (OS), in patients diagnosed with operable early-stage non-small cell lung cancer (NSCLC).Design Prospe...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e085076.full |
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| author | Jing Cheng Yang Du Karl Sylvester Shaoping Wu Suixin Liu Yaoshan Dun Baiyang You Siqian Fu Ning Xu Jeffrey William Ripley-Gonzalez Ni Cui |
| author_facet | Jing Cheng Yang Du Karl Sylvester Shaoping Wu Suixin Liu Yaoshan Dun Baiyang You Siqian Fu Ning Xu Jeffrey William Ripley-Gonzalez Ni Cui |
| author_sort | Jing Cheng |
| collection | DOAJ |
| description | Objectives Investigate the correlation between the percentage of predicted forced expiratory volume in 1 s (FEV1%pred) and survival outcomes, namely relapse-free survival (RFS) and overall survival (OS), in patients diagnosed with operable early-stage non-small cell lung cancer (NSCLC).Design Prospective observational study.Setting Clinical settings in Xiangya Hospital, Central South University, Hunan, China.Participants From November 2014 to December 2019, 775 operable patients with NSCLC, median age 58 years (IQR 13) with 40.6% women, were consecutively enrolled and underwent preoperative FEV1 assessment. All participants were evaluated using the FEV1%pred assessment. Subsequent treatments and operative interventions followed established protocols for NSCLC.Results During the follow-up, which lasted a median of 40 months (range 1–85 months) and continued until December 2021, 202 patients either relapsed or died. Optimal FEV1%pred cut-off was identified using receiver operating characteristic analysis. Results revealed 110 and 71 relapses and deaths per 1000 person-years for patients with FEV1 values of <82%pred and ≥82%pred, respectively. Cox proportional hazards models, adjusted for demographics, medical history and surgery characteristics with propensity score overlap weighting, revealed the significant impact of lower FEV1%pred on decreased RFS and OS. An FEV1%pred less than 82% displayed a significant association with decreased RFS (weighted HR, 1.55; 95% CI, 1.14 to 2.09; p=0.007) and OS (weighted HR, 1.50; 95% CI, 1.01 to 2.23; p=0.04).Conclusions Lower FEV1%pred values notably correlate with compromised RFS and OS in individuals operable for early-stage NSCLC, suggesting that FEV1%pred may serve as a valuable tool in evaluating and managing long-term recurrence risk in patients with early-stage NSCLC.Trial registration number ChiCTR2100048120. |
| format | Article |
| id | doaj-art-d4e0ca9028e24a2893d0d3e350c26c45 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d4e0ca9028e24a2893d0d3e350c26c452025-01-14T13:15:10ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-085076Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weightingJing Cheng0Yang Du1Karl Sylvester2Shaoping Wu3Suixin Liu4Yaoshan Dun5Baiyang You6Siqian Fu7Ning Xu8Jeffrey William Ripley-Gonzalez9Ni Cui105 Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China2 National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University, Changsha, Hunan, China4 Cambridge Respiratory Physiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China2 National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University, Changsha, Hunan, China1 Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China1 Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China1 Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China6 Department of Data Analytics and Application, Ping An Technology, Shanghai, China1 Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China1 Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, ChinaObjectives Investigate the correlation between the percentage of predicted forced expiratory volume in 1 s (FEV1%pred) and survival outcomes, namely relapse-free survival (RFS) and overall survival (OS), in patients diagnosed with operable early-stage non-small cell lung cancer (NSCLC).Design Prospective observational study.Setting Clinical settings in Xiangya Hospital, Central South University, Hunan, China.Participants From November 2014 to December 2019, 775 operable patients with NSCLC, median age 58 years (IQR 13) with 40.6% women, were consecutively enrolled and underwent preoperative FEV1 assessment. All participants were evaluated using the FEV1%pred assessment. Subsequent treatments and operative interventions followed established protocols for NSCLC.Results During the follow-up, which lasted a median of 40 months (range 1–85 months) and continued until December 2021, 202 patients either relapsed or died. Optimal FEV1%pred cut-off was identified using receiver operating characteristic analysis. Results revealed 110 and 71 relapses and deaths per 1000 person-years for patients with FEV1 values of <82%pred and ≥82%pred, respectively. Cox proportional hazards models, adjusted for demographics, medical history and surgery characteristics with propensity score overlap weighting, revealed the significant impact of lower FEV1%pred on decreased RFS and OS. An FEV1%pred less than 82% displayed a significant association with decreased RFS (weighted HR, 1.55; 95% CI, 1.14 to 2.09; p=0.007) and OS (weighted HR, 1.50; 95% CI, 1.01 to 2.23; p=0.04).Conclusions Lower FEV1%pred values notably correlate with compromised RFS and OS in individuals operable for early-stage NSCLC, suggesting that FEV1%pred may serve as a valuable tool in evaluating and managing long-term recurrence risk in patients with early-stage NSCLC.Trial registration number ChiCTR2100048120.https://bmjopen.bmj.com/content/14/12/e085076.full |
| spellingShingle | Jing Cheng Yang Du Karl Sylvester Shaoping Wu Suixin Liu Yaoshan Dun Baiyang You Siqian Fu Ning Xu Jeffrey William Ripley-Gonzalez Ni Cui Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting BMJ Open |
| title | Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting |
| title_full | Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting |
| title_fullStr | Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting |
| title_full_unstemmed | Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting |
| title_short | Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting |
| title_sort | association between forced expiratory volume in 1 s and relapse free survival in operable non small cell lung cancer a prospective cohort study with propensity score overlap weighting |
| url | https://bmjopen.bmj.com/content/14/12/e085076.full |
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