Department of General and Thoracic Surgery, University Hospital Schleswig Holstein, Campus Kiel, Arnold-Heller-Str 3, Haus 18, 24105 Kiel, Germany.
Lung Cancer. 2010 Apr;68(1):115-20. doi: 10.1016/j.lungcan.2009.05.019. Epub 2009 Jul 8.
Health-related quality of life (QOL) after resection of non-small cell lung cancer (NSCLC) is of primary interest to clinicians, secondary to clinical outcome. However, few studies have explored QOL following lung resection and, to our knowledge, no studies have specifically examined the QOL of elderly patients.
A total of 131 patients with NSCLC underwent surgical resection (lobectomy or bilobectomy) between January 1998 and December 2004 and were enrolled in our prospective study. The patients' QOL and clinical data were assessed prior to resection and for up to 24 months after surgery using the EORTC QLQ C-30 questionnaire and the lung-specific questionnaire, QLQ-LC13. Quality of life was then calculated and the QOL of patients younger than 70 years was compared with that of patients aged 70 years or older.
The overall 5-year survival rate was 47%, and the rate of complications did not differ significantly between the groups. Overall, most QOL indicators, including physical function (p<0.001), pain (p=0.025), and dyspnea (p<0.001) were significantly impaired after surgery and remained so for up to 24 months. Elderly patients survived for an average of 39 months, while younger patients survived for an average of 49 months (p=0.18). The QOL of younger patients returned to preoperative levels significantly faster than did the QOL of elderly patients.
Elderly patients who underwent lung resection for NSCLC failed to make a complete recovery. They showed a decreased tendency to achieve the preoperative level of QOL compared to younger patients.
与非小细胞肺癌(NSCLC)切除术后相关的健康相关生活质量(QOL)是临床医生的主要关注点,仅次于临床结果。然而,很少有研究探讨肺切除术后的 QOL,据我们所知,尚无研究专门研究老年患者的 QOL。
1998 年 1 月至 2004 年 12 月期间,共有 131 例 NSCLC 患者接受了手术切除(肺叶切除术或双肺叶切除术),并被纳入我们的前瞻性研究。在切除术前和手术后长达 24 个月,使用 EORTC QLQ C-30 问卷和肺特异性问卷 QLQ-LC13 评估患者的 QOL 和临床数据。然后计算生活质量,并将 70 岁以下患者的 QOL 与 70 岁及以上患者的 QOL 进行比较。
总体 5 年生存率为 47%,两组之间的并发症发生率无显著差异。总体而言,大多数 QOL 指标,包括身体功能(p<0.001)、疼痛(p=0.025)和呼吸困难(p<0.001)在手术后明显受损,并持续至 24 个月。老年患者的平均存活时间为 39 个月,而年轻患者的平均存活时间为 49 个月(p=0.18)。年轻患者的 QOL 恢复到术前水平的速度明显快于老年患者。
接受 NSCLC 肺切除术的老年患者未能完全康复。与年轻患者相比,他们恢复到术前 QOL 水平的趋势下降。