Liu Ming, Wampfler Jason A, Dai Jie, Gupta Ruchi, Xue Zhiqiang, Stoddard Shawn M, Cassivi Stephen D, Jiang Gening, Yang Ping
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, United States; Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, United States.
Lung Cancer. 2017 Apr;106:37-41. doi: 10.1016/j.lungcan.2017.01.014. Epub 2017 Jan 29.
To assess the pulmonary function and quality of life (QOL) after chest wall resection for non-small cell lung cancer.
One hundred and thirty-five patients (cases) who underwent pulmonary resection with chest wall removal were identified from January 1997 to December 2015. Propensity score matching (1:3) was applied to balance known confounders for pulmonary function and QOL between the cases and the control group who underwent pulmonary resection without chest wall invasion. Matched analyses were performed to compare perioperative mortality and morbidity, postoperative pulmonary function, overall QOL, and specific symptoms.
Perioperative mortality and morbidity did not differ significantly between cases and controls, but the hospital stay was longer in cases than in controls (mean, 12.8 vs 8.9days; p<0.001), The decline of postoperative pulmonary forced vital capacity (FVC) and the percentage of predicted FVC (FVC%) was more obvious in cases than in controls at 6 months and 2 years after surgery, but there was no obvious decline in the forced expiratory volume in one second (FEV1), the percentage of predicted FEV1 (FEV1%), the diffusion capacity of the lung for carbon monoxide (DLCO) and the percentage of predicted DLCO (DLCO%) in cases compared with controls. No significant difference was observed between the two groups in scores for overall QOL, pain, fatigue, cough, dyspnea, appetite, hemoptysis, lung cancer symptoms, and normal activities.
When chest wall resection is inevitable, it does not worse the QOL and pulmonary function of patients who underwent pulmonary resection with chest wall removal obviously compared with patients underwent pulmonary resection without chest wall invasion.
评估非小细胞肺癌胸壁切除术后的肺功能和生活质量（QOL）。
从1997年1月至2015年12月确定135例行肺切除并胸壁切除的患者（病例）。应用倾向评分匹配（1:3）来平衡病例组与未发生胸壁侵犯的肺切除对照组之间已知的肺功能和生活质量混杂因素。进行匹配分析以比较围手术期死亡率和发病率、术后肺功能、总体生活质量及特定症状。
病例组和对照组围手术期死亡率和发病率无显著差异，但病例组住院时间比对照组更长（平均，12.8天对8.9天；p<0.001）。术后6个月和2年时，病例组肺用力肺活量（FVC）及预计FVC百分比（FVC%）的下降比对照组更明显，但病例组一秒用力呼气量（FEV1）、预计FEV1百分比（FEV1%）、肺一氧化碳弥散量（DLCO）及预计DLCO百分比（DLCO%）与对照组相比无明显下降。两组在总体生活质量、疼痛、疲劳、咳嗽、呼吸困难、食欲、咯血、肺癌症状及正常活动评分方面无显著差异。
当胸壁切除不可避免时，与未发生胸壁侵犯的肺切除患者相比，胸壁切除对行肺切除并胸壁切除患者的生活质量和肺功能并无明显恶化影响。
