Balduyck Bram, Hendriks Jeroen, Lauwers Patrick, Sardari Nia Peyman, Van Schil Paul
Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Wilrijkstraat 10, Edegem B-2650, Belgium.
Eur J Cardiothorac Surg. 2009 Jun;35(6):1070-5; discussion 1075. doi: 10.1016/j.ejcts.2009.01.050. Epub 2009 Mar 14.
To prospectively evaluate quality of life (QoL) evolution after lung cancer surgery in a cohort of septuagenarians with the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire-C30 and LC13.
Between January 2003 and December 2006, QoL was prospectively recorded in 60 consecutive septuagenarians undergoing lung cancer surgery. Forty-nine lobectomies and 11 pneumonectomies were performed. Questionnaires were administered before surgery and 1, 3, 6 and 12 months postoperatively (MPO) with response rates of 100%, 83%, 87%, 90% and 77%, respectively.
After lobectomy, QoL scores returned to baseline 3-6 months after surgery, with the exception of a persistent decrease in physical functioning and an increase in dyspnea within the 12 months follow-up. In the 12 months follow-up period after pneumonectomy, there was no return to baseline in physical, role and social functioning. After pneumonectomy, most quality of life scores returned to baseline at 1-month follow-up, with the exception of dyspnea and general pain, which returned to baseline at 3 and 6 months, respectively. Comparing both resections, significant differences in evolution of physical functioning (6MPO p=0.045), role functioning (3MPO p=0.035), social functioning (6MPO p=0.006, 12MPO p=0.001) and general pain (6MPO p=0.037) were reported in favor of lobectomy.
The present study documented QoL evolution profiles of septuagenarians after pulmonary surgery. The results indicate that both resections have a major impact on elderly patients, especially physical functioning and dyspnea status. If both resections are compared, lobectomy patients have a more favorable evolution in QoL subscales compared to pneumonectomy.
采用欧洲癌症研究与治疗组织(EORTC)生活质量问卷-C30和LC13,对一组七旬老人肺癌手术后的生活质量(QoL)演变进行前瞻性评估。
2003年1月至2006年12月期间,对连续60例接受肺癌手术的七旬老人进行前瞻性QoL记录。实施了49例肺叶切除术和11例全肺切除术。术前及术后1、3、6和12个月(MPO)发放问卷,回复率分别为100%、83%、87%、90%和77%。
肺叶切除术后,QoL评分在术后3 - 6个月恢复至基线水平,但在12个月随访期内,身体功能持续下降,呼吸困难加重。在全肺切除术后12个月随访期内,身体、角色和社会功能未恢复至基线水平。全肺切除术后,大多数生活质量评分在1个月随访时恢复至基线水平,但呼吸困难和全身疼痛分别在3个月和6个月恢复至基线水平。比较两种切除术,在身体功能演变(6MPO p = 0.045)、角色功能(3MPO p = 0.035)、社会功能(6MPO p = 0.006,12MPO p = 0.001)和全身疼痛(6MPO p = 0.037)方面,肺叶切除术显示出显著差异。
本研究记录了七旬老人肺手术后的QoL演变情况。结果表明,两种切除术对老年患者均有重大影响,尤其是身体功能和呼吸困难状况。如果比较两种切除术,肺叶切除术患者在QoL子量表方面的演变比全肺切除术更有利。