Longitudinal changes in pulmonary function and patient-reported outcomes after lung cancer surgery
- 주제(키워드) Non-small cell lung cancer , Patients reported outcomes , Pulmonary function , Surgery
- 주제(기타) Respiratory System
- 설명문(일반) [Shin, Sumin] Ewha Womans Univ, Sch Med, Dept Thorac & Cardiovasc Surg, Seoul, South Korea; [Shin, Sumin; Cho, Jong Ho; Shim, Young Mog; Kim, Hong Kwan] Sungkyunkwan Univ, Samsung Med Ctr, Dept Thorac & Cardiovasc Surg, Sch Med, 81 Irwon Ro, Seoul 06351, South Korea; [Kong, Sunga; Kang, Danbee; Lee, Genehee; Cho, Juhee; Kim, Hong Kwan] Sungkyunkwan Univ, Dept Clin Res Design & Evaluat, SAIHST, Seoul, South Korea; [Kong, Sunga; Lee, Genehee; Shim, Young Mog; Cho, Juhee; Kim, Hong Kwan; Park, Hye Yun] Samsung Med Ctr, Patient Ctr Outcomes Res Inst, Seoul, South Korea; [Kang, Danbee; Cho, Juhee] Samsung Med Ctr, Ctr Clin Epidemiol, Seoul, South Korea; [Cho, Juhee] Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA; [Park, Hye Yun] Sungkyunkwan Univ, Samsung Med Ctr, Sch Med, Div Pulm & Crit Care Med,Dept Med, 81 Irwon Ro, Seoul 06351, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold, Green Submitted
- 발행기관 BMC
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000194616
- 본문언어 영어
- Published As https://doi.org/10.1186/s12931-022-02149-9
- PubMed https://pubmed.ncbi.nlm.nih.gov/36042472
초록/요약
Background: Surgery is the mainstay of treatment for non-small cell lung cancer, but the decline in pulmonary function after surgery is noticeable and requires attention. This study aimed to evaluate longitudinal changes in pulmonary function and integrated patient-reported outcomes (PROs) after lung cancer surgery. Methods: Data were obtained from a prospective cohort study, the Coordinate Approach to Cancer Patients' Health for Lung Cancer. Changes in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) at 2 weeks, 6 months, and 1 year after surgery, and the corresponding modified Medical Research Council (mMRC) dyspnea scale and chronic obstructive lung disease assessment test (CAT) scores were evaluated. Mixed effects model was used to investigate changes in pulmonary function and PROs. Results: Among 620 patients, 477 (76.9%) underwent lobectomy, whereas 120 (19.4%) and 23 (3.7%) were treated with wedge resection/segmentectomy and bilobectomy/pneumonectomy, respectively. Both FVC and -FEV1 markedly decreased 2 weeks after surgery and improved thereafter; however, they did not recover to baseline values. The corresponding mMRC dyspnea scale and CAT scores worsened immediately after surgery. The dyspnea scale of the mMRC was still higher, while CAT scores returned to baseline one year after surgery, although breathlessness and lack of energy persisted. Compared to the changes from baseline of FVC and -FEV1 in patients who underwent lobectomy, patients who underwent bilobectomy/pneumonectomy showed a greater decrease in FVC and -FEV1, while wedge resection/segmentectomy patients had smaller decreases in FVC and -FEV1 at 2 weeks, 6 months, and 1 year after surgery. Bilobectomy/pneumonectomy patients had the highest mMRC dyspnea grade among the three groups, but the difference was not statistically significant one year after surgery. Conclusions: After lung cancer surgery, pulmonary function and PROs noticeably decreased in the immediate postoperative period and improved thereafter, except for dyspnea and lack of energy. Proper information on the timeline of changes in lung function and symptoms following lung cancer surgery could guide patient care approaches after surgery.
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