Prospective study of quality of life after lung cancer resection

Hopkins, Kathleen Garrubba; Ferson, Peter F.; Shende, Manisha; Christie, Neil A.; Schuchert, Matthew J.; Pennathur, Arjun

doi:10.21037/atm.2017.04.34

Cited by 23 publications

(16 citation statements)

References 16 publications

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“…Larger studies have explored HRQL after VATS but have been retrospective or crosssectional in design and do not measure HRQL pre-operatively. 8,9 Prospective studies measuring HRQL before and after VATS surgery have typically been small in size or used unvalidated or generic instruments that measure broad aspects of health, which may not adequately capture the complex and unique areas of function impaired by lung cancer 6,[10][11][12][13] or studied few patients. 11 Between 2008 and 2014, Bendixen and colleagues 14 questionnaire, a generic measure of health status; EORTC core quality of life questionnaire (QLQ-C30); pain rating scale] at baseline and at several time points for 12 months post-operatively.…”

Section: Graphic Abstractmentioning

confidence: 99%

Impact on Health-Related Quality of Life of Video-Assisted Thoracoscopic Surgery for Lung Cancer

et al. 2019

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Background. Video-assisted thoracoscopic surgery (VATS) approaches are increasingly used in lung cancer surgery, but little is known about their impact on patients' health-related quality of life (HRQL). This prospective study measured recovery and HRQL in the year after VATS for non-small cell lung cancer (NSCLC) and explored the feasibility of HRQL data collection in patients undergoing VATS or open lung resection. Patients and Methods. Consecutive patients referred for surgical assessment (VATS or open surgery) for proven/suspected NSCLC completed HRQL and fatigue assessments before and 1, 3, 6 and 12 months post-surgery. Mean HRQL scores were calculated for patients who underwent VATS (segmental, wedge or lobectomy resection). Paired t-tests compared mean HRQL between baseline and expected worst (1 month), early (3 months) and longer-term (12 months) recovery time points. Results. A total of 92 patients received VATS, and 18 open surgery. Questionnaire response rates were high (presurgery 96-100%; follow-up 67-85%). Pre-surgery, VATS patients reported mostly high (good) functional health scores [(European Organisation for Research and Treatment of Cancer) EORTC function scores [ 80] and low (mild) symptom scores (EORTC symptom scores \ 20). One-month post-surgery, patients reported clinically and statistically significant deterioration in overall health and physical, role and social function (19-36 points), and increased fatigue, pain, dyspnoea, appetite loss and constipation [EORTC 12-26; multidimensional fatigue inventory (MFI-20) 3-5]. HRQL had not fully recovered 12 months post-surgery, with reduced physical, role and social function (10-14) and persistent fatigue and dyspnoea (EORTC 12-22; MFI-20 2.7-3.2). Conclusions. Lung resection has a considerable detrimental impact on patients' HRQL that is not fully resolved 12 months post-surgery, despite a VATS approach.

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Section: Graphic Abstractmentioning

confidence: 99%

Impact on Health-Related Quality of Life of Video-Assisted Thoracoscopic Surgery for Lung Cancer

et al. 2019

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“…For oncological surgery, resection status and survival rates seem to be more of clinical interest. However, more and more studies appeared focussing on quality of life after surgery, showing a decline during short-and long-term follow-up [28][29][30]. Different AEs, such as chronic pain, anxiety/depression or general mental function are increasingly moving into focus.…”

Section: Discussionmentioning

confidence: 99%

Adverse events reporting in stage III NSCLC trials investigating surgery and radiotherapy

et al. 2020

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BackgroundCurrent treatment options for stage III non-small cell lung cancer (NSCLC) consist of different combinations of chemotherapy, surgery, radiotherapy and immunotherapy. Treatment choices are highly individual decisions, in which adverse events (AEs) are relevant for decision-making. This study aims to analyse reporting of AEs in prospective stage III NSCLC trials, focussing on trials including radiotherapy and/or surgery.MethodsPubMed was searched for prospective studies dealing with stage III NSCLC from January 1987 to April 2019. Meta-analyses were screened as a positive control. Pearson's Chi-squared test and smooth kernel distribution were used to estimate distributions. Data was resampled using bootstrapping.ResultsOut of 1193 initially identified studies, 119 met the inclusion criteria. Of these, 31 had a surgical procedure in any study arm. Grade 3 and 4 AEs were reported in 94.12% and 92.44% of the included studies, respectively. Reporting of grade 5 AEs was provided in 87.39% of cases. Grade 1 and 2 AEs were less commonly reported at 53.78% and 63.03%, respectively. One study did not mention any AEs. Of the 31 treatment arms including any form of surgery, AEs were not reported in 10. Overall, 231 different AE items were reported, only 18 of them were included in at least 20% of the analysed studies.ConclusionOverall, AE reporting in stage III NSCLC was inconsistent and inhomogeneous. Studies including surgical study arms often reported only treatment-related deaths in regards of surgical AEs. Underreporting of AEs prohibits the extraction of patient-relevant information for decision-making and represents a suboptimal use of invested resources.

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“…In particular, their emotional, psychological, and physical scores were better than those in the malignant group. In their study on quality of life among patients with lung cancer, Hopkins et al [11] reported that patients had more pain and mood disorders in the first 6 months postoperatively. However, long-term quality of life was similar in patients who underwent VATS and those who had thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effect of video-assisted thoracoscopic surgery on early postoperative pain and quality of life

Cansever¹,

Sezen²,

Bedirhan³

2019

Curr Thorac Surg

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Background: Video-assisted thoracoscopic surgery (VATS) is more advantageous than open surgery. In particular, VATS is superior in terms of pain, physical functioning, and overall patient satisfaction. The aim of this study was to evaluate factors affecting early postoperative pain and quality of life in patients who underwent VATS for benign or malignant disease. Materials and Methods: Seventy-seven patients who underwent VATS in our hospital between March 1 and June 30, 2018 were evaluated retrospectively. Postoperative pain was assessed at 2, 6, and 24 hours postoperatively using Visual Analogue Scale (VAS). The short-form 36 (SF-36) quality of life questionnaire was used to assess early quality of life. Results: Of the 74 patients in the study, 50 were male (67.6%) and 24 were female (32.4%). Mean VAS score was 6.84 ± 1.63 at postoperative hour 2, 4.19 ± 1.36 at postoperative hour 6, and 2.58 ± 1.20 at postoperative day 1. Geriatric patients had significantly higher VAS pain scores at postoperative hour 6 and day 1 (p = 0.011, p = 0.013). Patients with benign disease had significantly higher quality of life compared to patients with malignancy (p < 0.001). The presence of complications and advanced age were associated with lower postoperative quality of life. Conclusions: Although VATS patients have less severe pain and better quality of life in the early postoperative period, patients with malignancy had worse physical, psychological, and emotional state. In addition, geriatric patients and patients with early postoperative complications showed larger decreases in early postoperative quality of life.

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Prospective study of quality of life after lung cancer resection

Cited by 23 publications

References 16 publications

Impact on Health-Related Quality of Life of Video-Assisted Thoracoscopic Surgery for Lung Cancer

Impact on Health-Related Quality of Life of Video-Assisted Thoracoscopic Surgery for Lung Cancer

Adverse events reporting in stage III NSCLC trials investigating surgery and radiotherapy

Evaluation of the effect of video-assisted thoracoscopic surgery on early postoperative pain and quality of life

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