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肺癌患者行电视辅助胸腔镜手术时,肌肉减少症与非肌肉减少症患者术后早期的患者报告结局

Early Postoperative Patient-Reported Outcomes of Sarcopenia Versus Nonsarcopenia in Patients Undergoing Video-Assisted Thoracoscopic Surgery for Lung Cancer.

作者信息

Liu Jieke, Li Dongyan, Ma Huijie, Li Yong, Wei Xing, Dai Wei, Shi Qiuling, Li Qiang, Zhou Peng, Wang Xiang, Qing Haomiao

机构信息

Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.

Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Ann Surg Oncol. 2025 Feb;32(2):801-810. doi: 10.1245/s10434-024-16140-9. Epub 2024 Aug 31.

Abstract

BACKGROUND

To compare early postoperative patient-reported outcomes between sarcopenic and nonsarcopenic patients undergoing video-assisted thoracoscopic surgery (VATS) for lung cancer.

METHODS

The data used in this study were acquired from a longitudinal prospective study (CN-PRO-Lung 1) between November 2017 and January 2020. Skeletal muscle index was measured at L3 vertebral level on preoperative computed tomography to identify sarcopenia based on an established threshold. Symptoms severity and status of functional impairments were reported as proportions of patients with clinically relevant moderate-to-severe scores on 0-10 scales, which were measured by using the MD Anderson Symptom Inventory-Lung Cancer at baseline, daily postoperative hospitalization, and weekly after discharge up to 4 weeks. Symptom severity, functional status, and postoperative clinical outcomes were compared between the sarcopenia and nonsarcopenia groups.

RESULTS

This study included 125 patients undergoing VATS for lung cancer. Sarcopenia was identified in 34 (27.2%) patients. Sarcopenic patients reported more moderate-to-severe pain (P = 0.002) at discharge and more moderate-to-severe fatigue (P = 0.027) during the 4 weeks after discharge. Besides, sarcopenic patients had a longer recovery time from both pain (P = 0.002) and fatigue (P = 0.007) than nonsarcopenic patients. Meanwhile, no significant between-group difference was found in the postoperative clinical outcomes (all P > 0.05).

CONCLUSIONS

Sarcopenic patients undergoing VATS for lung cancer may have more pain and fatigue, as well as longer symptoms recovery time than nonsarcopenic patients during the early postoperative period.

摘要

背景

比较接受电视辅助胸腔镜手术(VATS)治疗肺癌的肌肉减少症患者和非肌肉减少症患者术后早期的患者报告结局。

方法

本研究使用的数据来自2017年11月至2020年1月期间的一项纵向前瞻性研究(CN-PRO-Lung 1)。术前通过计算机断层扫描在L3椎体水平测量骨骼肌指数,以根据既定阈值确定肌肉减少症。症状严重程度和功能障碍状态以在0-10量表上具有临床相关中重度评分的患者比例报告,这些评分在基线、术后每日住院期间以及出院后每周测量一次,直至4周。比较肌肉减少症组和非肌肉减少症组之间的症状严重程度、功能状态和术后临床结局。

结果

本研究纳入了125例接受VATS治疗肺癌的患者。34例(27.2%)患者被确定为肌肉减少症。肌肉减少症患者出院时报告有更多中重度疼痛(P = 0.002),出院后4周内有更多中重度疲劳(P = 0.027)。此外,肌肉减少症患者从疼痛(P = 0.002)和疲劳(P = 0.007)中恢复的时间比非肌肉减少症患者更长。同时,术后临床结局在组间未发现显著差异(所有P > 0.05)。

结论

接受VATS治疗肺癌的肌肉减少症患者在术后早期可能比非肌肉减少症患者有更多疼痛和疲劳,以及更长的症状恢复时间。

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