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FIGURE LEGENDS

Figure 1. Cumulative incidence of subacute pneumonia after radical esophagectomy.

Figure 2. Receiver operating characteristic curves for physical activity (steps/day) to predict

the development of pneumonia.

26

27

TABLES

Table 1. Patients characteristics

Pneumonia (+)

Pneumonia (-)

n = 10

n = 73

72.5 (62.0–76.0)

67.0 (60.0–71.0)

0.310

Female

2 (20.0)

16 (21.9)

1.000

Male

8 (80.0)

57 (78.1)

21.9 ± 2.6

22.1 ± 2.6

0.842

0 (0.0%)

0 (0.0%)

1.000

Normal

7 (70.0)

44 (60.3)

0.824

Risk for undernutrition

3 (30.0)

26 (35.6)

Undernutrition

0 (0.0)

3 (4.1)

2 (20.0)

9 (12.3)

0.615

1 (10.0)

15 (20.5)

0.376

1–399

0 (0.0)

10 (13.7)

≥ 400

9 (90.0)

48 (65.8)

4 (40.0)

34 (46.6)

p-value

Age (years)

Median (IQR)

Sex

Body mass index (kg/m2)

Mean ± SD

Performance status

≥2

Nutrition status

Sarcopenia

yes

Brinkman Index

Comorbidity

Hypertension

0.748

27

28

Diabetes

1 (10.0)

13 (17.8)

1.000

Cardiovascular disease

0 (0.0)

8 (11.0)

0.587

Pulmonary disease

1 (10.0)

4 (5.5)

0.483

%VC

98.0 ± 16.6

104.6 ± 13.2

0.216

FEV1%

72.1 ± 3.5

75.7 ± 7.3

0.172

Upper thoracic

1 (10.0)

7 (9.6)

0.526

Middle thoracic

7 (70.0)

33 (45.2)

Lower thoracic

2 (20.0)

26 (35.6)

Abdominal esophagus

0 (0.0)

7 (9.6)

Pulmonary Function Test

Location of tumor

Histology

Squamous

cell 10 (100.0)

65 (89.0)

0.587

carcinoma

Adenocarcinoma

0 (0.0)

8 (11.0)

1-2

4 (40.0)

35 (47.9)

3-4

6 (60.0)

38 (52.1)

Not administered

1 (10.0)

14 (19.2)

Chemotherapy

7 (70.0)

52 (71.2)

Chemoradiotherapy

2 (20.0)

7 (9.6)

6 (60.0)

53 (72.6)

Clinical stage

0.743

Neoadjuvant therapy

0.495

Intraoperative variables

Surgical approach

Thoracoscopy-assisted

0.465

28

29

Mediastinoscopy-

4 (40.0)

20 (27.4)

Two-field

2 (20.0)

21 (28.8)

Three-field

8 (80.0)

52 (71.2)

subcutaneous

2 (20.0)

3 (4.1)

retrosternal

7 (70.0)

57 (76.1)

posterior mediastinal

1 (10.0)

13 (17.8)

638.0 (501.0–712.0)

582.0 (512.0–672.0)

0.611

93.5 (77.0–208.5)

150.0 (74.0–310.5)

0.471

2.0 (2.0–5.5)

2.0 (2.0–4.0)

0.695

8.0 (8.0–9.0)

0.037

2.0 (2.0–2.0)

0.221

4.0 (4.0–6.0)

0.858

1,406.6 ± 311.4

0.835

assisted

Lymph node dissection

0.719

Reconstruction route

0.164

Operative time (min)

Median (IQR)

Blood loss (ml)

Median (IQR)

Postoperative outcomes

Postoperative

oxygenation (days)

Initiation of oral intake 12.0 (9.0–23.8)

(days)

Initiation of Ambulation 2.0 (2.0–2.0)

(days)

Chest

tube

removal 4.5 (3.0–8.5)

(days)

Total

energy

intake 1,384.6 ± 318.8

(kcal/day)

Physical

activity 1,479.5

(1,173.0– 2,848.0

(2,234.0– 0.013

29

30

(steps/day)

2,518.5)

4,268.0)

Albumin level (g/dl)

2.8 (2.7-2.9)

3.0 (2.7–3.10)

0.333

CRP level (mg/dl)

5.1 (2.6-9.0)

2.34 (1.1–4.9)

0.066

Recurrent nerve paralysis

3 (30.0)

21 (28.8)

1.000

Anastomotic leakage

3 (30.0)

14 (19.2)

0.420

Surgical site infection

2 (20.0)

17 (23.3)

1.000

Length of stay (days)

45.5 (31.0–60.5)

24.0 (18.0–36.0)

0.002

Data are expressed as n (%) unless otherwise specified. IQR, interquartile range; SD, standard

deviation; %VC, percentage of vital capacity; FEV1%, forced expiratory volume ％ in 1 s.

30

31

Table 2. Univariate and multivariate analyses on the impact of physical activity on

postoperative pneumonia

Variable (reference)

Univariate analysis

OR

95% CI

multivariate analysis

p-

OR

95% CI

value

pvalue

Physical activity (NPA)

LPA

12.20

2.82–

0.001

12.10

52.60

2.21–

0.004

65.90

Age (<70 years)

≥70 years

3.06

0.79–

0.106

1.37

11.90

Reconstruction

0.28–

0.698

6.81

route

(retrosternal)

subcutaneous

5.43

0.77–

0.090

3.92

38.30

posterior mediastinal

0.63

0.07–5.54 0.674

0.36–

0.260

42.20

0.75

0.07–

0.808

7.87

Recurrent nerve paralysis

31

32

(no)

yes

1.06

0.25–4.50 0.936

0.54

0.09–

0.504

3.35

CI, confidence interval; OR, odds ratio; NPA, normal physical activity; LPA, low physical

activity

32

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