Impact on health-related quality of life of video-assisted thoracoscopic surgery for lung cancer: A prospective study in patients with non-small cell lung cancer

Kerry N. L. Avery, Jane M. Blazeby, Katy A. Chalmers, Timothy J. P. Batchelor, Gianluca Casali, Eveline Internullo, Rakesh Krishnadas, Clare Evans, Doug West

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Abstract

BackgroundVideo-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.
MethodsConsecutive 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 (3m) and longer-term (12m) recovery time-points.

Results92 patients received VATS and 18 open surgery. Questionnaire response rates were high (pre-surgery 96-100%; follow-up 67-85%). Pre-surgery, VATS patients reported mostly high (good) functional health scores (EORTC function scores >80) and low (mild) symptom scores (EORTC symptom scores <20). One-month post-surgery, patients reported clinically and statistically significant deteriorations in overall health and physical, role and social function (range 19-36 points), and increased fatigue, pain, dyspnoea, appetite loss and constipation (EORTC 12-26; MFI-20 3-5). HRQL had not fully recovered 12 months post-surgery, with reduced physical, role and social function (range 10-14) and persistent fatigue and dyspnoea (EORTC 12-22; MFI-20 2.7-3.2).

ConclusionLung resection has a considerable detrimental impact on patients’ HRQL that is not fully resolved 12 months post-surgery, despite a VATS approach.
Original languageEnglish
Number of pages13
JournalAnnals of Surgical Oncology
DOIs
Publication statusPublished - 1 Dec 2019

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