Department of Rehabilitative Medicine, Campus Biomedico University, Rome, Italy.
Clin Lung Cancer. 2013 Jan;14(1):78-87. doi: 10.1016/j.cllc.2012.04.002. Epub 2012 May 17.
The determinants and predictors of QOL in lung cancer survivors who have received surgery remain defined vaguely and still debated. We evaluate clinical, surgical, and pulmonary function characteristics as predictors of QOL in long-term lung cancer survivors who received surgery.
Quality of life was evaluated 5 years after surgery in 67 lung cancer patients using the European Organization for Research and Treatment of Cancer (EORTC) QOL Core Questionnaire, its lung cancer-specific module QLQ LC-13, and the Hospital Anxiety and Depression Scale questionnaire. Preoperative clinical, surgical, and pathologic data were matched with the questionnaire scores.
Sex was associated with role functioning and symptoms, with males more often reporting fatigue and pain, appetite loss, coughing, and hemoptysis (P < .05). Lower education was associated with better cognitive functioning (P < .05). Symptoms were worse for younger patients and for those with major comorbidity. Histology marginally influenced the global health status (P < .10) and the cognitive functioning (P < .05). Patients receiving complementary therapy more easily suffered from fatigue and insomnia (P < .05), and to a lesser extent from nausea and vomiting, constipation, and stress related to financial difficulties (P < .10). Higher values of forced expiratory volume at the first second (FEV(1)) and forced vital capacity (FVC) were significantly (P < .05) associated with a lower frequency of nausea and vomiting and appetite loss, while low percentage levels of FEV(1) and FVC were associated with lower global function and a greater severity of specific and nonspecific symptoms (P < .10 and P < .05).
Several preoperative features, particularly those reflecting pulmonary function, were moderately associated with QOL in long-term survivors and may be useful to address therapeutic strategies in lung cancer patients after surgery.
接受手术的肺癌幸存者生活质量的决定因素和预测因素仍定义不明确，仍存在争议。我们评估了临床、手术和肺功能特征，作为接受手术的长期肺癌幸存者生活质量的预测因素。
在 67 例肺癌患者手术后 5 年，使用欧洲癌症研究与治疗组织（EORTC）生活质量核心问卷、肺癌特异性模块 QLQ LC-13 和医院焦虑抑郁量表问卷评估生活质量。将术前临床、手术和病理数据与问卷评分相匹配。
性别与角色功能和症状有关，男性更常报告疲劳和疼痛、食欲减退、咳嗽和咯血（P<0.05）。较低的教育程度与更好的认知功能有关（P<0.05）。年轻患者和合并症较多的患者症状更严重。组织学对总体健康状况（P<0.10）和认知功能（P<0.05）有轻微影响。接受补充治疗的患者更容易出现疲劳和失眠（P<0.05），以及较少的恶心和呕吐、便秘和与经济困难相关的压力（P<0.10）。用力呼气第一秒量（FEV1）和用力肺活量（FVC）的较高值与恶心和呕吐以及食欲减退的频率降低显著相关（P<0.05），而 FEV1 和 FVC 的低百分比水平与总体功能降低以及特定和非特定症状的严重程度增加相关（P<0.10 和 P<0.05）。
几项术前特征，特别是反映肺功能的特征，与长期幸存者的生活质量中度相关，可能有助于为手术后肺癌患者制定治疗策略。
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