Quality of life and survival in the 2 years after surgery for non-small-cell lung cancer
Quality of life and survival in the 2 years after surgery for non-small-cell lung cancer
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DOI：
10.1200/jco.2006.07.7230
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发表时间：
2008-01-10
影响因子：
45.3
通讯作者：
McCaughan, Brian C.
中科院分区：
文献类型：
--
作者：
Kenny, Patricia M.;King, Madeleine T.;McCaughan, Brian C.
目的尽管已知早期非小细胞肺癌 (NSCLC) 手术对健康相关生活质量 (HRQOL) 具有重大影响，但关于长期 HRQOL 的已发表研究很少。本文检查了手术后 2 年的 HRQOL 和生存率。 患者和方法 临床 I 期或 II 期 NSCLC 患者 (n = 173) 在手术前、出院时、手术后 1 个月以及之后每 4 个月完成一次 HRQOL 问卷，持续 2 年。 HRQOL 通过通用癌症问卷（欧洲癌症研究和治疗组织生活质量问卷 [EORTC-QLQ] C30）和肺癌特异性问卷（EORTC QLQ-LC13）进行测量。对数据进行分析，以检查手术和任何后续治疗的影响，并描述 2 年内保持无病状态的患者和随访期间诊断出癌症复发的患者的轨迹。结果 36% 的患者在 2 年内疾病复发，2 年生存率为 65%。手术大大降低了除了情绪功能之外的所有维度的 HRQOL。对于没有疾病复发的患者，HRQOL 在手术后 2 年内有所改善，尽管大约一半的患者继续出现症状和功能限制。对于两年内复发的患者，术后早期 HRQOL 有所恢复，但随后大多数维度都出现恶化。 结论 手术对 HRQOL 产生重大影响，尽管许多无病幸存者经历了恢复，但有些患者仍存在长期 HRQOL 受损。 HRQOL 通常随着疾病复发而恶化。该研究结果对于可手术 NSCLC 患者的知情决策和持续支持护理非常重要。
PurposeAlthough surgery for early-stage non-small-cell lung cancer ( NSCLC) is known to have a substantial impact on health-related quality of life (HRQOL), there are few published studies about HRQOL in the longer term. This article examines HRQOL and survival in the 2 years after surgery.Patients and MethodsPatients with clinical stage I or II NSCLC (n = 173) completed HRQOL questionnaires before surgery, at discharge, 1 month after surgery, and then every 4 months for 2 years. HRQOL was measured with a generic cancer questionnaire (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire [ EORTC-QLQ] C30) and a lung cancer-specific questionnaire (EORTC QLQ-LC13). Data were analyzed to examine the impact of surgery and any subsequent therapy, and to describe the trajectories of those who remained disease free at 2 years and those with recurrent cancer diagnosed during follow-up.ResultsDisease recurred within 2 years for 36% of patients and 2-year survival was 65%. Surgery substantially reduced HRQOL across all dimensions except emotional functioning. HRQOL improved in the 2 years after surgery for patients without disease recurrence, although approximately half continued to experience symptoms and functional limitations. For those with recurrence within 2 years, there was some early postoperative recovery in HRQOL, with subsequent deterioration across most dimensions.ConclusionSurgery had a substantial impact on HRQOL, and although many disease-free survivors experienced recovery, some lived with long-term HRQOL impairment. HRQOL generally worsened with disease recurrence. The study results are important for informed decision making and ongoing supportive care for patients with operable NSCLC.