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J. Thorac. Cardiovasc. Surg. · Sep 2022
Long-term patient-reported outcomes after non-small cell lung cancer resection.
- Brendan T Heiden, Melanie P Subramanian, Jingxia Liu, Angela Keith, Kathryn E Engelhardt, Bryan F Meyers, Varun Puri, and Benjamin D Kozower.
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Mo; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Mo.
- J. Thorac. Cardiovasc. Surg. 2022 Sep 1; 164 (3): 615-626.e3.
ObjectivesPatient-reported outcomes (PROs) are critical tools for evaluating patients before and after lung cancer resection. In this study, we assessed patient-reported pain, dyspnea, and functional status up to 1 year postoperatively.MethodsThis study included patients who underwent surgery for non-small cell lung cancer at a single institution (2017-2020). We collected PROs using the National Institutes of Health Patient Reported Outcome Measurement Information System (PROMIS). Data were prospectively collected and merged with our institutional Society of Thoracic Surgeons data. Using multivariable linear mixed effect models, we compared PROMIS scores for preoperative and several postoperative visits.ResultsFrom 2017 until 2020, 334 patients underwent lung cancer resection with completed PROMIS assessments. Pain interference, physical function, and dyspnea severity scores were worse 1 month after surgery (P < .001). Pain interference and physical function scores returned to baseline by 6 months after surgery. However, dyspnea severity scores remained persistently worse up to 1 year after surgery (1-month difference, 8.8 ± 1.9; 6-month difference, 3.6 ± 2.2; 1-year difference, 4.9 ± 2.8; P < .001). Patients who received a thoracotomy had worse physical function and pain interference scores 1 month after surgery compared with patients who received a minimally invasive operation; however, there were no differences in PROs by 6 months after surgery.ConclusionsPROs are important metrics for assessing patients before and after lung cancer resection. Patients may report persistent dyspnea up to 1 year after resection. Additionally, patients undergoing thoracotomy initially report worse pain and physical function but these impairments improve by 6 months after surgery.Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
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