Early Post-discharge Pain Trajectories After Thoracoscopic Sublobar Resection for Stage IA Non-small Cell Lung Cancer

Jieke Liu^#¹, Huijie Ma^#¹, Dongyan Li¹, Yong Li¹, Haomiao Qing¹, Xing Wei², Qiuling Shi², Qiang Li^{2

3}, Wei Dai⁴, Peng Zhou⁵

Affiliations

¹ Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China.
² Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China.
³ State Key Laboratory of Ultrasound Engineering in Medicine, School of Public Health, Chongqing Medical University, Chongqing, China.
⁴ Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China. daiwei@sichuancancer.org.
⁵ Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China. penghyzhou@126.com.

^# Contributed equally.

PMID: 40853628
DOI: 10.1245/s10434-025-18183-y

Early Post-discharge Pain Trajectories After Thoracoscopic Sublobar Resection for Stage IA Non-small Cell Lung Cancer

Jieke Liu et al. Ann Surg Oncol. 2025.

. 2025 Aug 25.

doi: 10.1245/s10434-025-18183-y. Online ahead of print.

Authors

Jieke Liu^#¹, Huijie Ma^#¹, Dongyan Li¹, Yong Li¹, Haomiao Qing¹, Xing Wei², Qiuling Shi², Qiang Li^{2

3}, Wei Dai⁴, Peng Zhou⁵

Affiliations

¹ Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China.
² Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China.
³ State Key Laboratory of Ultrasound Engineering in Medicine, School of Public Health, Chongqing Medical University, Chongqing, China.
⁴ Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China. daiwei@sichuancancer.org.
⁵ Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, Chengdu, China. penghyzhou@126.com.

^# Contributed equally.

PMID: 40853628
DOI: 10.1245/s10434-025-18183-y

Abstract

Background: Thoracoscopic sublobar resection is emerging as a main treatment option for early-stage non-small cell lung cancer (NSCLC). This study aimed to determine whether distinct early post-discharge pain trajectories could be identified in patients with stage IA NSCLC undergoing thoracoscopic sublobar resection.

Methods: The data were collected from a longitudinal prospective observational cohort (CN-PRO-Lung 3). Pain severity was rated using a 0-10 scale, with assessments conducted before surgery and daily after discharge for up to 30 days. Post-discharge pain trajectories were identified using the latent class mixed model. Potential risk factors associated with different pain trajectory were explored, including preoperative clinical characteristics, body composition metrics derived from chest computed tomography, surgical methods, and postoperative clinical outcomes.

Results: A total of 439 patients were selected in the trajectory analysis. One trajectory comprised 65 patients (14.8%, unrecovered group) who experienced persistent moderated post-discharge pain, while the other comprised 374 patients (85.2%, recovered group) with mild post-discharge pain and a declining trend. The independent predictors for the unrecovered post-discharge pain trajectory included the subcutaneous fat index (odds ratio [OR] 1.031, 95% confidence interval [CI] 1.007-1.055, p = 0.010), preoperative pain severity (OR 1.428, 95% CI 1.102-1.851, p = 0.007), and hospital stay (OR 1.166, 95% CI 1.012-1.345, p = 0.034).

Conclusions: Patients with stage IA NSCLC undergoing thoracoscopic sublobar resection had two different early post-discharge pain trajectories. The higher subcutaneous fat index, more severe preoperative pain level, and longer hospital stay were associated with the unrecovered post-discharge pain.

Keywords: Non-small cell lung cancer; Pain trajectory; Post-discharge pain; Risk factor; Thoracoscopic sublobar resection.

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Conflict of interest statement

Disclosure: Jieke Liu, Huijie Ma, Dongyan Li, Yong Li, Haomiao Qing, Xing Wei, Qiuling Shi, Qiang Li, Wei Dai, and Peng Zhou declare they have no conflicts of interest that may be relevant to the contents of this study.

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Early Post-discharge Pain Trajectories After Thoracoscopic Sublobar Resection for Stage IA Non-small Cell Lung Cancer

Affiliations

Early Post-discharge Pain Trajectories After Thoracoscopic Sublobar Resection for Stage IA Non-small Cell Lung Cancer

Authors

Affiliations

Abstract

Conflict of interest statement

References

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