Preoperative evaluation of six-minute walk test in patients with malignant pleural mesothelioma

Objective: Surgical treatment of malignant pleural mesothelioma (MPM) is accompanied by high morbidity and mortality. The aim of this retrospective study was to characterize preoperative physical fitness and relate it to pulmonary functions, oxygenation, and postoperative outcomes in patients with MPM who underwent surgical resection with perioperative rehabilitation. Methods: A total of 18 patients were retrospectively reviewed. Preoperative exercise capacity was evaluated by the 6-min walk test (6MWT). Oxygen saturation of a peripheral artery (SpO₂) was measured during the 6MWT. Results: The 6-min walk distance was significantly correlated with inspiratory capacity and % of predicted diffusing capacity of the lung for carbon monoxide. The minimum SpO₂ during the 6MWT correlated with % of predicted vital capacity and total lung capacity and postoperative days of extubation. There were a total of 14 major complications in six patients. The incidence of major complications was associated with longer stays in intensive care unit and hospital but not with preoperative physical status or pulmonary functions. Conclusion: Our results indicate that the 6MWT is useful to assess preoperative physical status in patients with resectable MPM.