Liao Jia, Hu Xiaoqun, Wei Xing, Dai Wei, Yu Hongfan, Tian Xin, Wang Yaqin, Qin Qin, Xu Na, Li Yuanyuan, Li Qiang, Shi Qiuling, Liu Xiaoqin
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Chengdu, 610041, China.
State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
BMC Cancer. 2025 Apr 29;25(1):800. doi: 10.1186/s12885-025-14191-z.
Studies on sex-related differences in post-lung cancer surgery symptoms are limited. Understanding these differences may provide insights into patient recovery. Therefore, we investigated sex-related differences in these symptoms and their underlying associated factors.
We included patients aged ≥ 18 years undergoing surgery for lung cancer from a multicenter cohort study (CN-PRO-Lung 1) that focused on postoperative lung cancer symptoms trajectories. On a daily assessment schedule, we evaluated patients' symptoms and their impact on functioning from the day before surgery until discharge using the MD Anderson Symptom Inventory-Lung Cancer module. We evaluated sex-related differences in symptom scores over time and identified influencing factors using linear mixed models.
Of 372 eligible patients (196 men and 176 women;) symptoms were milder in men than in women for pain (estimate = 0.427, P = 0.021), fatigue (estimate = 1.071, P < 0.001), shortness of breath (estimate = 0.431, P = 0.021), lack of appetite (estimate = 0.728, P < 0.001), dry mouth (estimate = 0.438, P = 0.015), and constipation (estimate = 0.887, P < 0.001) during postoperative hospitalization (median: 7 days). Pain scores decreased over time in both sexes (estimate = -0.440 in men, P < 0.001; -0.510 in women, P < 0.001), while different factors were associated with increased pain in each group. In men, higher American Society of Anesthesiologists (ASA) classification (estimate = 0.430, P = 0.035), advanced pTNM stage (estimate = 0.550, P = 0.007), and having more than one chest drain (estimate = 0.690, P = 0.001) were associated with greater pain. In women, systematic lymph node dissection was associated with increased pain (estimate = 0.700, P = 0.033).
Women reported a higher symptom burden than men in the early postoperative period after lung cancer surgery. Key factors associated with worse postoperative pain include higher ASA classification, advanced pTNM stage, and more than one chest tube in men and systematic lymph node dissection in women.
NCT03341377.
关于肺癌手术后症状的性别差异研究有限。了解这些差异可能有助于深入了解患者的恢复情况。因此，我们调查了这些症状的性别差异及其潜在相关因素。
我们纳入了一项多中心队列研究（CN-PRO-Lung 1）中年龄≥18岁接受肺癌手术的患者，该研究关注肺癌术后症状轨迹。按照每日评估计划，我们使用MD安德森症状问卷-肺癌模块，评估患者从手术前一天直至出院的症状及其对功能的影响。我们评估了症状评分随时间的性别差异，并使用线性混合模型确定影响因素。
在372例符合条件的患者中（196例男性和176例女性），术后住院期间（中位数：7天），男性在疼痛（估计值=0.427，P=0.021）、疲劳（估计值=1.071，P<0.001）、呼吸急促（估计值=0.431，P=0.021）、食欲不振（估计值=0.728，P<0.001）、口干（估计值=0.438，P=0.015）和便秘（估计值=0.887，P<0.001）方面的症状比女性轻。男女两性的疼痛评分均随时间下降（男性估计值=-0.440，P<0.001；女性估计值=-0.510，P<0.001），而每组中不同因素与疼痛增加相关。在男性中，较高的美国麻醉医师协会（ASA）分级（估计值=0.430，P=0.035）、晚期pTNM分期（估计值=0.550，P=0.007）以及有不止一根胸腔引流管（估计值=0.690，P=0.001）与更严重的疼痛相关。在女性中，系统性淋巴结清扫与疼痛增加相关（估计值=0.700，P=0.033）。
肺癌手术后早期，女性报告的症状负担高于男性。与术后疼痛加重相关的关键因素包括男性较高的ASA分级、晚期pTNM分期和不止一根胸管，以及女性的系统性淋巴结清扫。
NCT03341377。
