Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May;5(10):204.
doi: 10.21037/atm.2017.04.34.

Prospective study of quality of life after lung cancer resection

Kathleen G Hopkins  1 , Peter F Ferson  2 , Manisha R Shende  3 , Neil A Christie  2 , Matthew J Schuchert  2 , Arjun Pennathur  2   4
Affiliations

Prospective study of quality of life after lung cancer resection

Kathleen G Hopkins et al. Ann Transl Med. 2017 May.

Abstract

Background: Surgical resection with curative-intent remains the gold standard for clinically operable early-stage non-small cell lung cancer (NSCLC). This goal can be accomplished using a minimally invasive option, e.g., video assisted thoracic surgery (VATS) or standard thoracotomy. Surgical techniques continue to evolve and few studies have compared the QOL of patients managed with these procedures using current approaches. The primary goal of this study was to investigate differences between patients managed surgically via VATS compared to thoracotomy with respect to ratings of chronic pain, anxiety/depression and quality of life (QOL). The secondary goal was to investigate differences between patients converted from VATS to thoracotomy versus those managed with the originally with thoracotomy.

Methods: We conducted a prospective cross sectional design study comparing the QOL after surgical resection of NSCLC. Data were obtained between 3-12 months postoperatively, from patients with potentially resectable stage I-IIIa NSCLC, who underwent a thoracotomy or VATS resection. All patients were consented. Pain was evaluated with a 0 to 10 numeric pain assessment scale (NAS), mood with the Hospital Anxiety and Depression Scale (HADS) (mood disorders) and QOL with FACT-L (Functional Assessment of Cancer Therapy-Lung).

Results: A total of 97 patients with stage I-IIIa lung cancer were enrolled; of these 66 (68%) underwent a standard thoracotomy and 31 (32%) underwent VATS resection. The preferred surgical approach was a thoracotomy for patients with stage IIIa lung cancer, or patients requiring a pneumonectomy or a bi-lobectomy. There were no significant differences between VATS and thoracotomy patients in ratings of chronic pain, mood disorders, or QOL. Conversion from VATS to thoracotomy occurred in 22 (23%) of patients. There were no significant differences between VATS conversion to thoracotomy and those with initial thoracotomy procedures in ratings of chronic pain, mood disorders, or QOL. Conversion from VATS to standard thoracotomy occurred more commonly early in the series.

Conclusions: While previous studies have shown that VATS offers an early advantage with regards to perioperative outcomes, our study demonstrated that VATS and thoracotomy patients had similar late QOL outcomes.

Keywords: Quality of life (QOL); lung cancer; minimally invasive surgery; surgery; video assisted thoracic surgery (VATS).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
A percent comparison of pain locations N=97. Percent comparison into the location of pain reported, based upon surgical approaches: number of patients by location of any chronic pain (N=97). Number of patients with a thoracotomy N=66 and those with VATS N=31. VATS, video assisted thoracic surgery.
Figure 2
Figure 2
A comparison of surgical approaches (N=97). A comparison of surgical approach: mean ratings of pain, mood disorder subscales & quality of life sub-scores N=97. The number of patients: thoracotomy n=66 and VATS n=31. VATS, video assisted thoracic surgery; QOL, quality of life.
Figure 3
Figure 3
A comparison of thoracotomy patients without and with a conversion (N=66). Thoracotomy patient comparisons (N=66). Patients without (n=44) and with (n=22) a conversion: ratings of pain, mood disorders & quality of life. VATS, video assisted thoracic surgery; QOL, quality of life.
See this image and copyright information in PMC

References

    1. American Cancer Society. Cancer Facts & Figures 2016. Available online: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts...
    1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology Non-Small Cell Lung Cancer V.3.2017. Available online: https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.o...
    1. Weiss AJ, Elixhauser A, Steiner C. Readmissions to U.S. Hospitals by Procedure, 2010. Available online: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb154.pdf - PubMed
    1. Whitson BA, Andrade RS, Boettcher A, et al. Video-Assisted Thoracoscopic Surgery is More Favorable Than Thoracotomy for Resection of Clinical Stage I Non-Small Cell Lung Cancer. Ann Thorac Surg 2007;83:1965-70. 10.1016/j.athoracsur.2007.01.049 - DOI - PubMed
    1. Blades B, Dugan DJ. War wounds of the chest observed at the Thoracic Surgery Center. Walter Reed General Hospital. J Thorac Surg 1944;13:294-306.

LinkOut - more resources