Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Seoul National University College of Medicine, Seoul, Korea.
Interact Cardiovasc Thorac Surg. 2021 Jan 22;32(2):276-283. doi: 10.1093/icvts/ivaa250.
The association between adjuvant chemotherapy (AC) and chronic postoperative pain (CPP) after video-assisted thoracoscopic surgery (VATS) for lung cancer resection has not yet been reported. We, therefore, investigated the association between AC and the long-term incidence of CPP after VATS.
We retrospectively reviewed 3015 consecutive patients who underwent VATS for lung cancer between 2007 and 2016. The patients were divided into 2 groups: those who received (AC group) and those who did not receive (non-AC group) AC within 3 months after VATS. Propensity score analysis was performed to adjust for baseline differences between the 2 groups. The cumulative incidence of CPP at the intervals of 3 months, over 36 months, was compared before and after matching. A Cox proportional hazards regression analysis was used to investigate the predictors of CPP after VATS.
We included and assessed 2222 patients in this study. Of these, 320 patients (14.4%) received AC within 3 months post-VATS. The cumulative incidence of CPP during 36 months post-surgery was significantly higher in the AC group than in the non-AC group, before and after matching (log-rank test; P = 0.002 and 0.027, respectively). Cox proportional hazards regression analysis also showed that AC was a significant risk factor for CPP (hazard ratio 1.62, 95% confidence interval 1.16-2.28; P = 0.005).
Our results indicate that AC is an important risk factor for CPP after VATS. Further understanding of the risk factors for CPP may facilitate its prediction and treatment.
电视辅助胸腔镜手术（VATS）肺癌切除术后辅助化疗（AC）与慢性术后疼痛（CPP）的关系尚未报道。因此，我们研究了 VATS 后 AC 与 CPP 长期发生率之间的关系。
我们回顾性分析了 2007 年至 2016 年间接受 VATS 治疗的 3015 例连续肺癌患者。患者分为两组：接受（AC 组）和未接受（非 AC 组）AC 的患者。在两组之间进行倾向评分分析以调整基线差异。比较匹配前后 3 个月和 36 个月间隔 CPP 的累积发生率。使用 Cox 比例风险回归分析来研究 VATS 后 CPP 的预测因素。
我们纳入并评估了 2222 例患者。其中，320 例（14.4%）患者在 VATS 后 3 个月内接受了 AC。AC 组在手术后 36 个月内 CPP 的累积发生率明显高于非 AC 组，匹配前后均有统计学差异（log-rank 检验；P=0.002 和 0.027）。Cox 比例风险回归分析也表明，AC 是 CPP 的一个显著危险因素（风险比 1.62，95%置信区间 1.16-2.28；P=0.005）。
我们的结果表明，AC 是 VATS 后 CPP 的一个重要危险因素。进一步了解 CPP 的危险因素可能有助于预测和治疗。
