Abstract
Objective: This study aimed to determine a target preoperative six-minute walk distance (6MWD) associated with shorter length of hospital stay (LOS) in patients undergoing subtotal stomach-preserving pancreatoduodenectomy (SSPPD) for pancreatic cancer.
Methods: Forty-four patients who underwent SSPPD between February 2018 and July 2023 were retrospectively analyzed. Patients were classified into early and prolonged LOS groups based on the median LOS. Receiver operating characteristic (ROC) analysis was performed to identify the optimal cutoff value of preoperative 6MWD, followed by between-group comparisons. Additionally, factors associated with prolonged LOS were examined within the low-6MWD subgroup.
Results: The optimal cutoff value of preoperative 6MWD was 490 m. Patients with a preoperative 6MWD <490 m were significantly more likely to experience prolonged hospitalization and showed a higher incidence of postoperative complications, poorer preoperative cognitive function, unfavorable inflammatory and immune-related markers (higher white blood cell count and lower lymphocyte percentage), and lower discharge 6MWD and activities of daily living (ADL). Within the low-6MWD subgroup, lower lymphocyte percentage and higher C-reactive protein levels were associated with prolonged LOS.
Conclusion: A preoperative 6MWD ≥490 m may represent a clinically meaningful target associated with LOS in patients undergoing SSPPD. Furthermore, combining inflammatory and immune markers with 6MWD may help stratify patients who require more intensive perioperative management.
