Skip to main content

Advertisement

SpringerLink
Log in

Relationship between changes in pulmonary function and patient-reported outcomes of lung cancer surgery

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To investigate the relationship between changes in pulmonary function (PF) and patient-reported outcomes (PROs) of lung cancer surgery.

Methods

We recruited 262 patients who underwent lung resection for lung cancer, to evaluate the PROs, using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30 and the Lung Cancer 13-question supplement (LC13). The patients underwent PF tests and PRO assessments preoperatively (Pre) and 1 year after surgery (Y1). Changes were calculated by subtracting the value at Pre from the value at Y1. We set two cohorts: patients under the ongoing protocol (Cohort 1) and patients who were eligible for lobectomy with clinical stage I lung cancer (Cohort 2).

Results

Cohorts 1 and 2 comprised 206 and 149 patients, respectively. In addition to dyspnea, changes in PF were also correlated with scores for global health status, physical and role function scores, fatigue, nausea and vomiting, pain, and financial difficulties. Absolute correlation coefficient values ranged from 0.149 to 0.311. Improvement of emotional and social function scores was independent of PF. Sublobar resection preserved PF more than lobectomy did. Wedge resection mitigated dyspnea in both cohorts.

Conclusion

The correlation between PF and PROs was found to be weak; therefore, further studies are needed to improve the patient’s postoperative experience.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Suzuki K, Watanabe SI, Wakabayashi M, Saji H, Aokage K, Moriya Y, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg. 2022;163(289–301): e2.

    Google Scholar 

  2. Saji H, Okada M, Tsuboi M, Nakajima R, Suzuki K, Aokage K, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022;399:1607–17.

    Article  PubMed  CAS  Google Scholar 

  3. Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K, Tsubota N. Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg. 2006;132:769–75.

    Article  PubMed  Google Scholar 

  4. Handa Y, Tsutani Y, Mimae T, Miyata Y, Okada M. Postoperative pulmonary function after complex segmentectomy. Ann Surg Oncol. 2021;28(13):8347–55.

    Article  PubMed  Google Scholar 

  5. Tane S, Nishio W, Nishioka Y, Tanaka H, Ogawa H, Kitamura Y, et al. Evaluation of the residual lung function after thoracoscopic segmentectomy compared with lobectomy. Ann Thorac Surg. 2019;108:1543–50.

    Article  PubMed  Google Scholar 

  6. Ueda K, Tanaka T, Hayashi M, Li TS, Tanaka N, Hamano K. Computed tomography-defined functional lung volume after segmentectomy versus lobectomy. Eur J Cardiothorac Surg. 2010;37:1433–7.

    Article  PubMed  Google Scholar 

  7. Suzuki H, Morimoto J, Mizobuchi T, Fujiwara T, Nagato K, Nakajima T, et al. Does segmentectomy really preserve the pulmonary function better than lobectomy for patients with early-stage lung cancer? Surg Today. 2017;47:463–9.

    Article  PubMed  CAS  Google Scholar 

  8. Stamatis G, Leschber G, Schwarz B, Brintrup DL, Ose C, Weinreich G, et al. Perioperative course and quality of life in a prospective randomized multicenter phase III tria, comparing standard lobectomy versus anatomical segmentectomy in patients with non-small cell lung cancer up to 2cm, stage IA (7th edition of TNM staging system). Lung Cancer. 2019;138:19–26.

    Article  PubMed  Google Scholar 

  9. Schwartz RM, Yip R, Flores RM, Olkin I, Taioli E, Henschke C, Investigators IE. The impact of resection method and patient factors on quality of life among stage IA non-small cell lung cancer surgical patients. J Surg Oncol. 2017;115:173–80.

    Article  PubMed  Google Scholar 

  10. Moller A, Sartipy U. Predictors of postoperative quality of life after surgery for lung cancer. J Thorac Oncol. 2012;7:406–11.

    Article  PubMed  Google Scholar 

  11. Fevrier E, Yip R, Becker BJ, Taioli E, Yankelevitz DF, Flores R, et al. Change in quality of life of stage IA lung cancer patients after sublobar resection and lobectomy. J Thorac Dis. 2020;12:3488–99.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sarna L, Evangelista L, Tashkin D, Padilla G, Holmes C, Brecht ML, et al. Impact of respiratory symptoms and pulmonary function on quality of life of long-term survivors of non-small cell lung cancer. Chest. 2004;125:439–45.

    Article  PubMed  Google Scholar 

  13. Shin S, Kong S, Kang D, Lee G, Cho JH, Shim YM, et al. Longitudinal changes in pulmonary function and patient-reported outcomes after lung cancer surgery. Respir Res. 2022;23:224.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Merlo A, Carlson R, Espey J 3rd, Williams BM, Balakrishnan P, Chen S, et al. Postoperative symptom burden in patients undergoing lung cancer surgery. J Pain Symptom Manage. 2022;64:254–67.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ichimura H, Kobayashi K, Gosho M, Nakaoka K, Yanagihara T, Ueda S, et al. Preoperative predictors of restoration in quality of life after surgery for lung cancer. Thorac cancer. 2021;12(6):835–44.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Ichimura H, Kobayashi K, Gosho M, Nakaoka K, Yanagihara T, Ueda S, et al. Trajectory and profile of quality of life in patients undergoing lung resection for lung cancer during hospitalization according to the EQ-5D. Gen Thorac Cardiovasc Surg. 2021;69(8):1204–13.

    Article  PubMed  Google Scholar 

  17. Ichimura H, Kobayashi K, Gosho M, Nakaoka K, Yanagihara T, Saeki Y, et al. (2021) Comparison of Postoperative Quality of Life and Pain with and without a Metal Rib Spreader in Patients Undergoing Lobectomy through Axillary Mini-Thoracotomy for Stage I Lung Cancer. Ann Thorac Cardiovasc Surg

  18. Suzuki K, Koike T, Asakawa T, Kusumoto M, Asamura H, Nagai K, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical IA lung cancer (Japan clinical oncology group 0201). J Thorac Oncol. 2011;6:751–6.

    Article  PubMed  Google Scholar 

  19. Kobayashi N, Kobayashi K, Kikuchi S, Goto Y, Ichimura H, Endo K, et al. Long-term pulmonary function after surgery for lung cancer. Interact Cardiovasc Thorac Surg. 2017;24:727–32.

    Article  PubMed  Google Scholar 

  20. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76.

    Article  PubMed  CAS  Google Scholar 

  21. Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M. The EORTC QLQ-LC13: a modular supplement to the EORTC core quality of life questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC study group on quality of life. Eur J Cancer. 1994;30A:635–42.

    Article  PubMed  CAS  Google Scholar 

  22. Balduyck B, Hendriks J, Lauwers P, Sardari Nia P, Van Schil P. Quality of life evolution after lung cancer surgery in septuagenarians: a prospective study. Eur J Cardiothorac Surg. 2009;35:1070–5 (discussion 5).

    Article  PubMed  Google Scholar 

  23. Kenny PM, King MT, Viney RC, Boyer MJ, Pollicino CA, McLean JM, et al. Quality of life and survival in the 2 years after surgery for non small-cell lung cancer. J Clin Oncol. 2008;26:233–41.

    Article  PubMed  Google Scholar 

  24. Koller M, Musoro JZ, Tomaszewski K, Coens C, King MT, Sprangers MAG, et al. Minimally important differences of EORTC QLQ-C30 scales in patients with lung cancer or malignant pleural mesothelioma - interpretation guidance derived from two randomized EORTC trials. Lung Cancer. 2022;167:65–72.

    Article  PubMed  CAS  Google Scholar 

  25. Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998;16:139–44.

    Article  PubMed  CAS  Google Scholar 

  26. Quist M, Sommer MS, Vibe-Petersen J, Staerkind MB, Langer SW, Larsen KR, et al. Early initiated postoperative rehabilitation reduces fatigue in patients with operable lung cancer: a randomized trial. Lung Cancer. 2018;126:125–32.

    Article  PubMed  Google Scholar 

  27. Bendixen M, Jorgensen OD, Kronborg C, Andersen C, Licht PB. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol. 2016;17:836–44.

    Article  PubMed  Google Scholar 

  28. Pompili C, Rogers Z, Absolom K, Holch P, Clayton B, Callister M, et al. Quality of life after VATS lung resection and SABR for early-stage non-small cell lung cancer: a longitudinal study. Lung Cancer. 2021;162:71–8.

    Article  PubMed  CAS  Google Scholar 

  29. Ojha UC, Singh DP, Choudhari OK, Gothi D, Singh S. Correlation of severity of functional gastrointestinal disease symptoms with that of asthma and chronic obstructive pulmonary disease: a multicenter study. Int J Appl Basic Med Res. 2018;8:83–8.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Revicki D, Hays RD, Cella D, Sloan J. Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol. 2008;61:102–9.

    Article  PubMed  Google Scholar 

  31. Nolte S, Liegl G, Petersen MA, Aaronson NK, Costantini A, Fayers PM, et al. General population normative data for the EORTC QLQ-C30 health-related quality of life questionnaire based on 15,386 persons across 13 European countries, Canada and the Unites States. Eur J Cancer. 2019;107:153–63.

    Article  PubMed  CAS  Google Scholar 

  32. Shiroiwa T, Fukuda T, Ikeda S, Igarashi A, Noto S, Saito S, et al. Japanese population norms for preference-based measures: EQ-5D-3L, EQ-5D-5L, and SF-6D. Qual Life Res : Int J Qual Life Asp Treat, Care Rehabilitat. 2016;25:707–19.

    Article  Google Scholar 

  33. Khullar OV, Wei JW, Wagh K, Binongo JN, Pickens A, Sancheti MS, et al. Preoperative lung function is associated with patient-reported outcomes after lung cancer surgery. Ann Thorac Surg. 2021;112:415–22.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was presented in part in 2022 at an oral session of the 39th annual meeting of the Japanese Association of Chest Surgery (Tokyo, Japan) and at an oral session of the 122nd Annual Scientific Meeting of the Japanese Surgical Society (Kumamoto, Japan).

Funding

None.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan

    Hideo Ichimura, Keisuke Kobayashi, Yasuharu Sekine, Kazuto Sugai, Tomoyuki Kawamura, Yusuke Saeki & Hisashi Suzuki

  2. Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Hideo Ichimura, Naohiro Kobayashi, Yukinobu Goto & Yukio Sato

  3. Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan

    Masahiko Gosho

Authors
  1. Hideo Ichimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keisuke Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiko Gosho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasuharu Sekine
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kazuto Sugai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tomoyuki Kawamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yusuke Saeki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hisashi Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Naohiro Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yukinobu Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yukio Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hideo Ichimura.

Ethics declarations

Conflict of interest

We have no conflicts of interest to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ichimura, H., Kobayashi, K., Gosho, M. et al. Relationship between changes in pulmonary function and patient-reported outcomes of lung cancer surgery. Surg Today 54, 195–204 (2024). https://doi.org/10.1007/s00595-023-02716-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-023-02716-7

Keywords

Search

Navigation