Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
School of Public Health and Management, Chongqing Medical University, Chongqing, China.
Ann Surg Oncol. 2021 Dec;28(13):8358-8371. doi: 10.1245/s10434-021-09981-1. Epub 2021 Apr 20.
The effects of video-assisted thoracoscopic surgery (VATS) and traditional thoracotomy with respect to patient-reported outcomes (PROs) have only been assessed for early-stage lung cancer. This study was a longitudinal PRO assessment to compare the effects of these surgeries for locally advanced (stage II and III) lung cancer from the patients' perspective.
We investigated lung cancer patients from a previous prospective, multicentre study. Longitudinal data of clinical characteristics and PROs were collected. PROs were obtained preoperatively, daily in the hospital postoperatively, and weekly up to 4 weeks after discharge or the beginning of postoperative adjuvant therapy. Symptoms and impact on daily functioning and quality of life (QOL) were assessed by using the MD Anderson Symptom Inventory for lung cancer and a single-item QOL scale. Trajectories of PROs over the investigation period were compared.
Overall, 117 primary lung cancer patients (stage II or III), including 63 and 54 patients who underwent VATS and traditional thoracotomy, respectively, were included. During postoperative hospitalization, VATS patients reported milder disturbed sleep (p = 0.048), drowsiness (p = 0.008), and interference with activity (p = 0.001), as well as better work ability (p < 0.0001), walking ability (p < 0.0001), and life enjoyment (p = 0.004). Post-discharge, VATS patients had less distress (p = 0.039), milder pain (p = 0.006), better work ability (p = 0.001), and better QOL (p = 0.047).
Locally advanced lung cancer patients who underwent VATS had lower postoperative symptom burden, less daily function interference, and better QOL than those who underwent thoracotomy.
胸腔镜手术（VATS）和传统开胸手术对患者报告的结果（PROs）的影响仅在早期肺癌中进行了评估。本研究是一项纵向 PRO 评估，旨在从患者角度比较这些手术对局部晚期（II 期和 III 期）肺癌的影响。
我们调查了来自先前前瞻性、多中心研究的肺癌患者。收集了临床特征和 PRO 的纵向数据。PRO 在术前、术后住院期间每天、出院后 4 周内或开始术后辅助治疗时每周收集。使用 MD 安德森肺癌症状量表和单项 QOL 量表评估症状以及对日常功能和生活质量（QOL）的影响。比较了整个研究期间 PRO 的轨迹。
共有 117 例原发性肺癌患者（II 期或 III 期），其中 63 例和 54 例患者分别接受了 VATS 和传统开胸手术。术后住院期间，VATS 患者报告睡眠障碍较轻（p=0.048）、困倦（p=0.008）和活动干扰较小（p=0.001），以及更好的工作能力（p<0.0001）、行走能力（p<0.0001）和生活享受（p=0.004）。出院后，VATS 患者的痛苦较轻（p=0.039）、疼痛较轻（p=0.006）、工作能力较好（p=0.001）和 QOL 较高（p=0.047）。
与开胸手术相比，接受 VATS 的局部晚期肺癌患者术后症状负担较低，日常功能干扰较小，生活质量较高。
