Subjective and objective assessment of quality of life after chest wall resection

Heuker, David; Lengelé, Benoît; Delecluse, Véronique; Weynand, Birgit; Liistro, Giuseppe; Balduyck, Bram; Noirhomme, Philippe; Poncelet, Alain

doi:10.1016/j.ejcts.2010.03.071

Cited by 21 publications

(16 citation statements)

References 24 publications

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“…Heuker et al 8 noticed that subjective assessment of dyspnea was correlated well with patient-perceived HRQoL. Results of our study also indicate that limitation in breathing can occur and HRQoL can be decreased.…”

Section: Discussionsupporting

confidence: 75%

“…7 Few previous studies assessing HRQoL in patients after chest wall tumor resection all have some limitations. [8][9][10][11][12] They are hampered by small sample size 8,9,11,12 ; fail to compare results obtained in patients to those of a healthy control population 8 , 10-12 ; or do not report the extent of the surgical operations, need for reconstruction, and methods of reconstruction. 9,10 There are no studies assessing postoperative HRQoL of patients with chest wall sarcoma.…”

Section: Introductionmentioning

confidence: 99%

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Health-related quality of life after oncological resection and reconstruction of the chest wall

Salo

Repo

Roine

et al. 2019

Journal of Plastic, Reconstructive & Aesthetic Surgery

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There is limited information of the health-related quality of life (HRQoL) after surgical treatment of chest wall tumors. This cross-sectional study aimed to assess long-term HRQoL after chest wall reconstruction following oncological resection. Methods: Seventy-eight patients having undergone chest wall tumor resection and reconstruction during 1997-2015 were invited to complete the 15D and QLQ-C30 HRQoL instruments. Results: Altogether, 55 patients (17 men and 38 women), with a mean (SD) age of 68 (14) years, completed the questionnaires (response rate 71%). Patients had been operated due to soft tissue sarcoma (n = 16), advanced breast cancer (n = 15), osteo-or chondrosarcoma (n = 14), or other tumor (n = 10). Median time after primary surgery was 66 (IQR 38, 141) months. The resection was full thickness in 29/55 cases and partial thickness in 26/55 cases. Chest wall reconstruction was required for 47/55 cases (85%). Reconstruction was performed using softtissue flap in eight cases, skeletal stabilizations with mesh or mesh-cement-mesh (sandwich method) in 15 cases, and skeletal stabilizations and soft-tissue flap in 24 cases. Patients' mean 15D score (0.878, SD 0.111) was comparable to that of the age-and genderstandardized general population (0.891, SD 0.041). Limitations in breathing and usual activities were noted. The QLQ-C30 cancer-specific HRQoL was 72 points (maximum 100). Scores in the QLQ-C30 Functional scales ranged from 78 (Physical) to 91 (Social).

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Health-related quality of life after oncological resection and reconstruction of the chest wall

Salo

Repo

Roine

et al. 2019

Journal of Plastic, Reconstructive & Aesthetic Surgery

View full text Add to dashboard Cite

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“…Heuker et al 23 . have recently reported on QOL changes in a series of patients undergoing chest wall resection for different diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Heuker et al 23 have recently reported on QOL changes in a series of patients undergoing chest wall resection for different diseases. This study differs from ours, in that QOL measurements were made in long-term survivors (>36 months).…”

Section: Discussionmentioning

confidence: 99%

The impact on quality of life after en‐bloc resection for non‐small‐cell lung cancer involving the chest wall

et al. 2012

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Background: En‐bloc resection for non‐small cell lung cancer with chest‐wall involvement may achieve a 5‐year survival rate higher than 40%, but the impact on postoperative quality of life is not yet known. Methods: Twenty‐six patients undergoing en‐bloc lung resections were included. Life quality ratings were assessed through a Short‐Form 36 questionnaire preoperatively and at six, 12, 18 and 24 month follow‐up visits. The degree of dyspnea, pain level, and flow‐volume curves were also obtained at the same time periods. Changes occurring over time were analyzed by means of repeated‐measure ANOVA. Results: As a whole, the Physical Component Summary score declined six months postoperatively (P < 0.0001) and failed to improve thereafter. Patients with preoperative Forced Expiratory Volume in one second (FEV1), <80% predicted (P = 0.029), resected ribs >2 (P = 0.03), and chest wall defect ≥50 cm2 (P = 0.007) experienced a greater and lasting impairment. Net postoperative decrease in FVC (P = 0.02; r = 0.48) and dyspnea worsening (P = 0.03; r =−043 at six months, P = 0.05; r =−0.39 at 12 months) were also correlated with the extent of physical deterioration, whereas age (P = 0.92), gender (P = 0.51), type of resection (P = 0.71), and adjuvant therapy (P = 0.68) did not. The Physical Component Summary didn't change significantly in patients with high pain levels (VAS >7). The Mental Component Summary score increased slightly at six months, with no difference in any patients' subgroup. Conclusions: The extent of chest wall resection, preoperative FEV1, and postoperative decline in FVC were the main indicators of quality of life impairment after en‐bloc resection for lung cancer. The impact upon quality of life should be considered in a cost‐to‐benefit ratio of planning this surgery in suboptimal candidates.

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“…Bisher wurden erst wenige Studien zur Lebensqualität der Langzeitüberleben-den von ausgedehnten radikalen Thoraxwandresektion nach Malignom veröf-fentlicht [3]. Es ist wichtig zu verstehen, dass radikale chirurgische Vorgehensweisen, welche eine freie mikrochirurgische Lappentransplantation beinhalten, technisch machbar sind; dennoch ist die postoperative interdisziplinäre Intensivtherapie der Schlüssel zu höheren Überlebens-raten in diesen verheerenden Fällen.…”

Section: Fazitunclassified

„Forequarter-Amputation“ des rechten oberen Rumpfs

Dragu

Hohenberger

Lang

et al. 2011

Chirurg

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Total forearm free flap procedures after forequarter amputations have been sparsely described in the literature. Using the amputated arm as a "free filet flap" remains a viable surgical option after radical forequarter amputations performed for the resection of large, invasive tumors of the shoulder or thoracic wall region. Using the forequarter specimen as a donor site seems favorable in that it eliminates the usual donor site morbidity. Nevertheless, in our patient with invasive ductal carcinoma of the breast and a fibrosarcoma suffering from severe pain and septic conditions - which failed to respond properly to conservative therapy - as well as rapidly progressive tumor ulceration despite repeated radiation therapy, we decided to attempt complete tumor removal by hemithoracectomy as a last resort. This decision was taken following multiple interdisciplinary consultations and thorough patient information. Although technically feasible with complete tumor removal and safe soft tissue free flap coverage, the postoperative course raises questions about the advisability of such ultra radical surgical procedures, as well as about the limitations of respiratory recovery after hemithoracectomy with removal of the sternum. Hence, based on our experience with such radical tumor surgery, we discuss the issues of diminished postoperative pulmonary function, intensive care possibilities and ethical issues. The English full-text version of this article is available at SpringerLink (under "Supplemental").

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Subjective and objective assessment of quality of life after chest wall resection

Abstract: This study shows that long-term survivors after extensive chest wall resection experienced moderate impairments in several QoL subscales. As previously reported in patients after pulmonary resection, subjective assessment such as dyspnoea correlated well with patient-perceived QoL.

Cited by 21 publications

References 24 publications

Health-related quality of life after oncological resection and reconstruction of the chest wall

Health-related quality of life after oncological resection and reconstruction of the chest wall

The impact on quality of life after en‐bloc resection for non‐small‐cell lung cancer involving the chest wall

„Forequarter-Amputation“ des rechten oberen Rumpfs

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