Quality of life after radical pleurectomy decortication for malignant pleural mesothelioma.

BACKGROUND

Malignant pleural mesothelioma is an aggressive malignancy in which radical surgical treatment appears to improve survival. It is unknown, however, if radical surgical treatment affects quality of life (QoL) adversely. Our objective was to assess patient-reported symptoms of health-related QoL after radical pleurectomy decortication (PD).

METHODS

Patients with malignant pleural mesothelioma were prospectively enrolled between 2010 and 2011 to determine the effects of PD on baseline QoL. Health-related QoL was assessed using the European Organization for Research and Treatment of Cancer core Quality of Life Questionnaire-C30 tool (EORTC QLQ-C30) before operation and at 1, 5 to 6, and 8 to 9 months postoperatively. Patients were grouped based on World Health Organization baseline performance status (PS) and compared.

RESULTS

Of the 28 patients enrolled, 16 (57.1%) and 12 (42.9%) were World Health Organization PS 0 and PS 1, respectively. At baseline, PS 1 patients had significantly worse global QoL functional and symptom scores at baseline. At 5 to 6 months' follow-up, PS 0 patients had no significant change in global QoL or functional domain scores. PS 1 patients had significant improvement in global QoL (p=0.038), symptoms of fatigue (p=0.05), and dyspnea (p=0.048). At 8 to 9 months' follow-up, PS 0 patients showed significant improvement in symptoms of fatigue (p=0.026) from baseline and PS 1 maintained the improvements in symptoms of fatigue (p=0.049) and dyspnea (p=0.048).

CONCLUSIONS

Radical PD does not negatively impact minimally symptomatic patients at intermediate follow-up. Patients who have symptoms at baseline can have significant improvement in their QoL after surgical treatment.