Gait Pace Predicts for Overall Survival in Advanced Cancer Patients

Abstract

Predicting survival is important to avoid over-treat or under treating patients. Stage, age, and performance status are all useful predictors for survival in cancer patients but further stratification would be helpful. on three prospective phase II studies 6-meter gait pace was collected prior to treatment. Studies include patients with locally advanced or metastatic cancer; 1. Radiosurgery for multiple brain mets (using radiosurgery as opposed to whole brain radiation for patients with stage IV disease with 5+ CNS mets) 2. Observation for small asymptomatic CNS mets (observation as opposed to treatment for patients with stage IV disease with no symptoms from the CNS metastatic lesion) 3. Radiosurgery for locally advanced lung cancer (stage III and unresectable stage II lung cancer treated with radiosurgery as opposed to conventional radiation). As a secondary endpoint for the above studies we measured 6 meter gait pace prior to treatment, patients were asked to walk 6 meters at a normal walking pace. total of 88 patients were analyzed from all three studies, median age was 62 years, and 76 patients had KPS of 70 or better. Overall survival for all patients is 560 days, 54 patients were alive at time of last follow-up. The median 6 meter gait pace for all patients is 8.0 seconds (8.0 for multiple met study, 8.2 for CNS observation, 7.3 for NSCLC study). There was statistical significant improvement in overall survival for patients with gait pace less than 7 seconds versus over 7 seconds (median survival 300 days versus not met) and also for 8 seconds (median survival 324 days versus 600 days). Gait pace may be a useful metric to help better predict survival. Gait pace is easy to obtain, non-subjective and we found it to have strong predicitve abiltiy for overall survival. Having better predictive tools for expected outcome can avoid over and under-treatment of patients and better stratify patients on future clinical studies.