Functional Capacity of Patients with Advanced Gastrointestinal and Breast Cancer Pre-treatment - a Cross-Sectional Comparison to Healthy Age-matched Women

Abstract Purpose: The aim of the study was to compare the functional status of patients with advanced gastrointestinal and breast cancer prior treatment to healthy age-matched volunteers. Methods: In this 3-arm cross-sectional study female patients with advanced cancer (UICC ≥ III) (gastrointestinal: n=17; 68.4±5.6years; BMI: 24±5.1kg/m2; breast: n=17; 64.1±7.8years; BMI: 23.6±3.7kg/m2) before first-line chemotherapy and 17 healthy age-matched women (68.6±5.8years; BMI 24.6±3.2kg/m2) were included. The functional status was assessed using the short physical performance battery (SPPB). A capacitive force platform was used for gait speed recordings during free level walking. Maximal isometric voluntary contraction force (MIVF) of the quadriceps muscle was assessed by a strain gauge force system. Body composition was obtained from bioelectrical-impedance-analysis. Physical activity was assessed via accelerometry. Results: Compared to the healthy controls and to patients with breast cancer, gastrointestinal cancer patients have lower values in the SPPB (10.4±1.3vs.8.9±2.0 vs.6.8±2.6; p<.01), phase angle (5.4±0.5°vs.5.2±0.5°vs.4.5±0.8°; p<.01), MIVF (8.8±1.9vs.9.2±3.5vs.6.0±2.1N/kg; p<.01), and gait speed (5.0±0.6vs.4.6±0.5vs. 3.6±1.1km/h; p<.01). The daily steps were significantly lower in gastrointestinal cancer patients compared to healthy women (3407±2408;8774±3975, p<.01).Conclusions: Already prior treatment patients with advanced gastrointestinal cancer have a reduced functional status compared to breast cancer patients and healthy controls. Gait speed, phase angle and MIVF are below cut-off values for a low prognosis of survival. This physical deconditioning prior treatment might influence the toxicity of the therapy. Thus, supportive interventions to improve the functional status and to support the treatment in patients with advanced gastrointestinal cancer seems to be of high concern.Trial Registration: Registered study at ClinicalTrials.gov (NCT02677129).