title: Prognostic validation of the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index in inoperable non-small-cell lung cancer.
abstract: BACKGROUND
  To investigate the prognostic utility of the body mass index, severity of airflow obstruction, measures of exertional dyspnea, and exercise capacity (BODE) index in patients with inoperable non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  One hundred consecutive patients with inoperable NSCLC and performance status 0 to 3 completed pulmonary function testing, the modified Medical Research Council dyspnea scale, a 6-minute walk test, and body mass index-the multidimensional 10-point BODE index. Cox proportional models were used to estimate the risk of all-cause mortality according to the BODE index with or without adjustment for traditional prognostic factors.
  
  
  RESULTS
  Median follow-up was 31.5 months; 61 deaths (61%) were reported during this period. There was a significant univariate association between the BODE index score and mortality (adjusted p(trend) = 0.027). Compared with patients with a BODE index of 0, the adjusted hazard ratio for risk of death was 1.37 (95% confidence interval [CI], 0.74-2.55) for a BODE index of 1, 1.22 (95% CI, 0.45-3.25) for a BODE index of 2, and 2.44 (95% CI, 1.19-4.99) for a BODE index more than 2. The BODE index provided incremental prognostic information beyond that provided traditional markers of prognosis (adjusted p(trend) = 0.051). Every one-point increase in the BODE index, the risk of death increased by 25% (hazard ratio = 1.25; 95% CI, 1.27-4.64).
  
  
  CONCLUSIONS
  The BODE index is a strong independent predictor of survival in inoperable NSCLC beyond traditional risk factors. Use of this multidimensional tool may improve risk stratification and prognostication in NSCLC.
authors.affiliation: *Physiotherapy Department, The University of Melbourne, Melbourne, Australia; †Duke Cancer Institute, Durham, North Carolina; and ‡Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Denehy
authors.forename: Whitney E
authors.initials: WE
authors.lastname: Hornsby
authors.forename: James E
authors.initials: JE
authors.lastname: Herndon
authors.forename: Samantha
authors.initials: S
authors.lastname: Thomas
authors.forename: Neal E
authors.initials: NE
authors.lastname: Ready
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Granger
authors.forename: Lauren
authors.initials: L
authors.lastname: Valera
authors.forename: Aarti A
authors.initials: AA
authors.lastname: Kenjale
authors.forename: Neil D
authors.initials: ND
authors.lastname: Eves
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000473:pathology; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000150:complications / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D015992:Body Mass Index; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000401:mortality / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality / Q000473:pathology; D004417:Dyspnea / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012129:Respiratory Function Tests; D015996:Survival Rate