Health-related quality of life after surgical treatment in patients with non-small cell lung cancer: a systematic review.

INTRODUCTION

Surgical resection currently is the best available treatment to enhance long-term survival after non-small cell lung cancer (NSCLC). With the anticipated growth in the number of NSCLC survivors diagnosed through computed tomography screening, health-related quality of life (HR-QOL) as an endpoint of treatment will become increasingly important. This article is a systematic review of the literature regarding HR-QOL in patients after surgical treatment.

METHODS

Three computerized databases (PubMed, Medline, and CINHAL) were used to identify relevant articles. Inclusion criteria were: empirical studies English language, assessment of HR-QOL after surgical treatment for stage I, II, or III NSCLC, and publication prior to January 2012. Data were abstracted and content analyses were used to synthesize the findings.

RESULTS

Nineteen out of 337 studies were reviewed. The majority of participants (67%) had stable or improved mental HR-QOL at 6-months after surgery. Compared with the general population, however, NSCLC survivors have poorer mental HR-QOL. Compared to pre-surgical status, participants had worse physical function at 6-months after surgery and had decreased physical function up to 2-years after surgery. Pain, fatigue, dyspnea and coughing were the most prevalent symptoms. Increased levels of dyspnea and fatigue persisted for at least 2-years after surgery. Continued smoking, presence of comorbidities, extensive surgical resection, and use of adjuvant therapy were associated with lower HR-QOL.

CONCLUSIONS

New interventions focused on smoking cessation, improving symptom control and physical function are needed to enhance HR-QOL after lung cancer surgery.