Schwartz Rebecca M, Yip Rowena, Flores Raja M, Olkin Ingram, Taioli Emanuela, Henschke Claudia
Department of Occupational Medicine, Epidemiology and Prevention (OMEP), Hofstra Northwell School of Medicine, Great Neck, New York.
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
J Surg Oncol. 2017 Feb;115(2):173-180. doi: 10.1002/jso.24478. Epub 2016 Oct 28.
Given the increased number of treatment options for stage IA lung cancer patients, there is a growing body of literature that focuses on comparing each option's relative impact on quality of life (QoL). The current study seeks to further understand the differences in these patients' QoL according to surgical approach.
Screening-diagnosed first primary pathologic stage IA non-small-cell lung cancer surgical patients from the I-ELCAP cohort who answered a baseline and 1-year follow-up QoL questionnaire (SF-12) were included in the analysis. Thoracotomy patients (N = 85) were compared with VATS patients (N = 15) using paired t-tests and analysis of variance tests.
Multivariate analyses indicated no differences in QoL change between the two groups from pre- to post-surgery. Physical and emotional role functioning significantly improved among VATS patients and worsened among thoracotomy patients. Among thoracotomy patients, a significant decrease in post-surgical physical QoL was observed only in those who underwent lobectomy (-3.3; 95% CI: -5.1,-1.5), not limited resection.
Although the sample size is small, preliminary findings underscore that changes in overall QoL are similar in VATS and thoracotomy stage IA lung cancer patients. Extension of the resection may be a more relevant factor on QoL post-surgery. J. Surg. Oncol. 2017;115:173-180. © 2016 Wiley Periodicals, Inc.
鉴于IA期肺癌患者的治疗选择不断增加，越来越多的文献聚焦于比较每种选择对生活质量（QoL）的相对影响。本研究旨在进一步了解这些患者根据手术方式不同在生活质量上的差异。
分析来自I-ELCAP队列的经筛查诊断为首个原发性病理IA期非小细胞肺癌且回答了基线和1年随访生活质量问卷（SF-12）的手术患者。采用配对t检验和方差分析，将开胸手术患者（N = 85）与电视辅助胸腔镜手术（VATS）患者（N = 15）进行比较。
多变量分析表明，两组患者术前至术后生活质量变化无差异。VATS患者的身体和情感角色功能显著改善，而开胸手术患者则恶化。在开胸手术患者中，仅接受肺叶切除术的患者术后身体生活质量显著下降（-3.3；95%可信区间：-5.1，-1.5），而非局限性切除术患者。
尽管样本量较小，但初步研究结果强调，VATS和开胸手术的IA期肺癌患者总体生活质量变化相似。扩大切除范围可能是影响术后生活质量的更相关因素。《外科肿瘤学杂志》2017年；115：173 - 180。© 2016威利期刊公司
