This multicenter retrospective cohort study (n=213, 3 Japanese institutions, July 2021–June 2023) compared the feasibility and incremental predictive value of the 30-s chair stand test (CS-30) vs. the 6-min walk test (6MWT) for postoperative pulmonary complications (PPCs) in esophageal cancer patients undergoing curative esophagectomy.
PPCs occurred in 57/213 patients (26.8%). CS-30 data completeness was higher than 6MWT (91.5% vs. 83.6%; p<0.001). Adding CS-30 to established risk factors raised AUC from 0.775 to 0.786, with significant NRI of 0.427 (p=0.004) and IDI of 0.048 (p=0.001). Adding 6MWT did not significantly improve prediction. CS-30 <15 reps was linked to longer hospital stay (27 vs. 22 days) and lower discharge rate (73% vs. 86%).
- Retrospective design with potential selection and information bias. - Key intraoperative variables (operative time, blood loss, surgical approach) were excluded from prediction models. - Missing data handled by imputation; complete-case analysis showed only a trend for CS-30 NRI improvement (p=0.056), not statistical significance.
Consider adding the CS-30 (cutoff <15 reps) to routine preoperative assessment for esophageal cancer surgery — it is quick, needs only a chair and stopwatch, and significantly improves PPC risk stratification. High-risk patients (CS-30 <15 reps) should be prioritized for prehabilitation and early mobilization planning.
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