Cancer Research Lab

Surgery for non-small-cell lung cancer can have a substantial impact on long-term health-related quality of life, results of a study published in the January issue of the Journal of Clinical Oncology suggest.

“Although 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,” Dr. Patricia Kenny, of the University of Technology, Sydney, New South Wales, Australia, and colleagues write.

The researchers examined short- and long-term HRQOL and survival in the 2 years after surgery in patients with clinical stage I or II NSCLC (n = 173). The patients completed HRQOL questionnaires before surgery, at discharge, 1 month after surgery, and then every 4 months for 2 years.

Overall, 36% of patients experienced disease recurrence within 2 years. Of these, 55% received palliative radiotherapy and 24% received palliative chemotherapy. The mean time from surgery to disease recurrence was 10.7 months. Postoperative in-hospital mortality was 3%. The 2-year survival rate was 65.2%.

Of the 173 patients, 10 had no postoperative HRQOL data. The patients showed substantial deterioration across all HRQOL domains except emotional functioning after surgery. For the patients without disease recurrence, HRQOL improved in the 2 years after surgery. However, approximately half of these patients continued to experience symptoms and functional limitations. Patients who experienced disease recurrence within 2 years had some early postoperative improvement in HRQOL, with subsequent deterioration in most domains.

“These results can provide useful information for clinicians preparing patients for lung cancer surgery,” Dr. Kenny’s team writes. “Although few (if any) would decline surgery, informed decision making requires a full understanding of the potential outcomes (including HRQOL). Information about the continuing HRQOL effects can also contribute to ensuring that appropriate ongoing management and support are provided.”