What Happens to Patients Undergoing Lung Cancer Surgery?
| Autor: | James W. Asaph, Carolyn E. Reed, Sydney Koh, Gerard A. Silvestri, Gary Y. Ott, Jr . John R. Handy, Andrew C. Tsen, Laurie Skokan, Gladney Brooks, E. Charles Douville |
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| Rok vydání: | 2002 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung cancer surgery SF-36 business.industry Respiratory disease Critical Care and Intensive Care Medicine medicine.disease Surgery Quality of life Cardiothoracic surgery DLCO medicine Adjuvant therapy Cardiology and Cardiovascular Medicine business Lung cancer |
| Zdroj: | Chest. 122:21-30 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.122.1.21 |
| Popis: | Objective To compare baseline preoperative and 6-month postoperative functional health status and quality of life in patients undergoing lung cancer resection. Methods Lung cancer surgery patients from three hospitals were administered the Short-Form 36 Health Survey (SF-36) and the Ferrans and Powers’ quality-of-life index (QLI) before surgery and 6 months after surgery. Preoperative, intraoperative, hospital stay, and 6-month postoperative clinical data were collected. All p values ≤ 0.05 were considered significant. Results One hundred thirty-nine patients were studied; 131 patients were discharged and 8 patients (5.8%) died. One hundred three patients (78.6%) who survived underwent an evaluation at 6 months, 16 patients (12.2%) died during follow-up, 2 patients refused follow-up, 4 patients were unavailable for follow-up, and 6 patients are awaiting an evaluation at 6 months. Compared with matched healthy subjects, preoperative lung cancer patients had worse results on the SF-36 physical functioning, role–emotional, mental health, and energy subscales. At 6 months, SF-36 subscales for physical functioning, role–physical, bodily pain, and mental health were significantly worse than preoperative values. The visual analog pain scale was significantly worse at follow-up. The QLI with all subscales and SF-36 for role–emotional, energy, and general health subscales were unaffected by lung cancer resection. Whereas preoperative FEV 1 and 6-min walk results did not predict postoperative functional health status or QLI, a low preoperative diffusion capacity of the lung for carbon monoxide (D lco ) predicted poor postoperative QLI. Preoperative chemoradiation, extent of resection, postoperative complications, or adjuvant therapy did not negatively affect the results of the 6-month QLI or SF-36. Conclusions Preoperative functional health status in patients who undergo lung cancer surgery is significantly impaired. A significant number of patients die during the 6 months after surgery. Pain and impairment of functional health status persists for 6 months after lung cancer resection. D lco , not FEV 1 , predicts postoperative quality of life. Preoperative chemoradiation, extent of resection, postoperative complications, or adjuvant therapy do not adversely affect functional health status or quality of life 6 months after surgery. Future studies should focus on risk prediction, technical improvements, and postoperative intervention to improve the functional outcomes and quality of life after lung cancer surgery. |
| Databáze: | OpenAIRE |
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