Age-related impairment of quality of life after lung resection for non-small cell lung cancer

Abstract

Background: Health-related quality of life (QOL) after resection of non-small cell lung cancer (NSCLC) is of primary interest to clinicians, secondary to clinical outcome. However, few studies have explored QOL following lung resection and, to our knowledge, no studies have specifically examined the QOL of elderly patients.

Methods: A total of 131 patients with NSCLC underwent surgical resection (lobectomy or bilobectomy) between January 1998 and December 2004 and were enrolled in our prospective study. The patients' QOL and clinical data were assessed prior to resection and for up to 24 months after surgery using the EORTC QLQ C-30 questionnaire and the lung-specific questionnaire, QLQ-LC13. Quality of life was then calculated and the QOL of patients younger than 70 years was compared with that of patients aged 70 years or older.

Results: The overall 5-year survival rate was 47%, and the rate of complications did not differ significantly between the groups. Overall, most QOL indicators, including physical function (p<0.001), pain (p=0.025), and dyspnea (p<0.001) were significantly impaired after surgery and remained so for up to 24 months. Elderly patients survived for an average of 39 months, while younger patients survived for an average of 49 months (p=0.18). The QOL of younger patients returned to preoperative levels significantly faster than did the QOL of elderly patients.

Conclusions: Elderly patients who underwent lung resection for NSCLC failed to make a complete recovery. They showed a decreased tendency to achieve the preoperative level of QOL compared to younger patients.