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Respiratory Research
Published in: Respiratory Research 1/2022

Open Access 01-12-2022 | NSCLC | Research

Longitudinal changes in pulmonary function and patient-reported outcomes after lung cancer surgery

Authors: Sumin Shin, Sunga Kong, Danbee Kang, Genehee Lee, Jong Ho Cho, Young Mog Shim, Juhee Cho, Hong Kwan Kim, Hye Yun Park

Published in: Respiratory Research | Issue 1/2022

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Abstract

Background

Surgery is the mainstay of treatment for non-small cell lung cancer, but the decline in pulmonary function after surgery is noticeable and requires attention. This study aimed to evaluate longitudinal changes in pulmonary function and integrated patient-reported outcomes (PROs) after lung cancer surgery.

Methods

Data were obtained from a prospective cohort study, the Coordinate Approach to Cancer Patients’ Health for Lung Cancer. Changes in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) at 2 weeks, 6 months, and 1 year after surgery, and the corresponding modified Medical Research Council (mMRC) dyspnea scale and chronic obstructive lung disease assessment test (CAT) scores were evaluated. Mixed effects model was used to investigate changes in pulmonary function and PROs.

Results

Among 620 patients, 477 (76.9%) underwent lobectomy, whereas 120 (19.4%) and 23 (3.7%) were treated with wedge resection/segmentectomy and bilobectomy/pneumonectomy, respectively. Both FVC and FEV1 markedly decreased 2 weeks after surgery and improved thereafter; however, they did not recover to baseline values. The corresponding mMRC dyspnea scale and CAT scores worsened immediately after surgery. The dyspnea scale of the mMRC was still higher, while CAT scores returned to baseline one year after surgery, although breathlessness and lack of energy persisted. Compared to the changes from baseline of FVC and FEV1 in patients who underwent lobectomy, patients who underwent bilobectomy/pneumonectomy showed a greater decrease in FVC and FEV1, while wedge resection/segmentectomy patients had smaller decreases in FVC and FEV1 at 2 weeks, 6 months, and 1 year after surgery. Bilobectomy/pneumonectomy patients had the highest mMRC dyspnea grade among the three groups, but the difference was not statistically significant one year after surgery.

Conclusions

After lung cancer surgery, pulmonary function and PROs noticeably decreased in the immediate post-operative period and improved thereafter, except for dyspnea and lack of energy. Proper information on the timeline of changes in lung function and symptoms following lung cancer surgery could guide patient care approaches after surgery.
Trial registration: ClinicalTrials.gov; No.: NCT03705546; URL: www.​clinicaltrials.​gov
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Literature
1.
Collaboration GBoDC. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3:524–48.CrossRef
2.
Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD, https://​seer.​cancer.​gov/​archive/​csr/​1975_​2017/​, based on November 2019 SEER data submission, posted to the SEER web site, April 2020.
3.
Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27:2758–65.PubMedCrossRef
4.
Howington JA, Blum MG, Chang AC, Balekian AA, Murthy SC. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143:e278S-e313S.PubMedCrossRef
5.
Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WEE, Nicholson AG, Groome P, Mitchell A, Bolejack V, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11:39–51.PubMedCrossRef
6.
Gu Z, Wang H, Mao T, Ji C, Xiang Y, Zhu Y, Xu P, Fang W. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis. 2018;10:2331–7.PubMedPubMedCentralCrossRef
7.
Bolliger CT, Jordan P, Soler M, Stulz P, Tamm M, Wyser C, Gonon M, Perruchoud AP. Pulmonary function and exercise capacity after lung resection. Eur Respir J. 1996;9:415–21.PubMedCrossRef
8.
Win T, Groves AM, Ritchie AJ, Wells FC, Cafferty F, Laroche CM. The effect of lung resection on pulmonary function and exercise capacity in lung cancer patients. Respir Care. 2007;52:720–6.PubMed
9.
Larsen KR, Svendsen UG, Milman N, Brenøe J, Petersen BN. Cardiopulmonary function at rest and during exercise after resection for bronchial carcinoma. Ann Thorac Surg. 1997;64:960–4.PubMedCrossRef
10.
Fitch MI. Exploring Experiences of Survivors and Caregivers Regarding Lung Cancer Diagnosis, Treatment, and Survivorship. J Patient Exp. 2020;7:193–9.PubMedCrossRef
11.
Lowery AE, Krebs P, Coups EJ, Feinstein MB, Burkhalter JE, Park BJ, Ostroff JS. Impact of symptom burden in post-surgical non-small cell lung cancer survivors. Support Care Cancer. 2014;22:173–80.PubMedCrossRef
12.
Hechtner M, Eichler M, Wehler B, Buhl R, Sebastian M, Stratmann J, Schmidberger H, Gohrbandt B, Peuser J, Kortsik C, et al. Quality of life in NSCLC survivors—a multicenter cross-sectional study. J Thorac Oncol. 2019;14:420–35.PubMedCrossRef
13.
Yang P, Cheville AL, Wampfler JA, Garces YI, Jatoi A, Clark MM, Cassivi SD, Midthun DE, Marks RS, Aubry MC, et al. Quality of life and symptom burden among long-term lung cancer survivors. J Thorac Oncol. 2012;7:64–70.PubMedPubMedCentralCrossRef
14.
Ostroff JS, Krebs P, Coups EJ, Burkhalter JE, Feinstein MB, Steingart RM, Logue AE, Park BJ. Health-related quality of life among early-stage, non-small cell, lung cancer survivors. Lung Cancer. 2011;71:103–8.PubMedCrossRef
15.
Gridelli C, Perrone F, Nelli F, Ramponi S, De Marinis F. Quality of life in lung cancer patients. Ann Oncol. 2001;12:S21–5.PubMedCrossRef
16.
Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M. The EORTC QLQ-LC13: a modular supplement to the EORTC Core Quality of Life Questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC Study Group on Quality of Life. Eur J Cancer. 1994;30A:635–42.PubMedCrossRef
17.
Ediebah DE, Coens C, Zikos E, Quinten C, Ringash J, King MT, Schmucker von Koch J, Gotay C, Greimel E, Flechtner H, et al: Does change in health-related quality of life score predict survival? Analysis of EORTC 08975 lung cancer trial. Br J Cancer 2014, 110:2427–2433.
18.
Solberg Nes L, Liu H, Patten CA, Rausch SM, Sloan JA, Garces YI, Cheville AL, Yang P, Clark MM. Physical activity level and quality of life in long term lung cancer survivors. Lung Cancer. 2012;77:611–6.PubMedCrossRef
19.
Pozo CL, Morgan MA, Gray JE. Survivorship issues for patients with lung cancer. Cancer Control. 2014;21:40–50.PubMedCrossRef
20.
Lee H, Kim HK, Kang D, Kong S, Lee JK, Lee G, Shin S, Cho J, Zo JI, Shim YM, Park HY. Prognostic value of 6-min walk test to predict postoperative cardiopulmonary complications in patients with non-small cell lung cancer. Chest. 2020;157:1665–73.PubMedCrossRef
21.
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CPM, Gustafsson P, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–38.PubMedCrossRef
22.
American Thoracic Society. Single-breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique–1995 update. Am J Respirat Crit Care Med. 1995;152:2185–98.CrossRef
23.
Choi JK, Paek D, Lee JO. Normal predictive values of spirometry in Korean population. TRD. 2005;58:230–42.
24.
Park JO, Choi IS, Park KO. Normal predicted values of single-breath diffusing capacity of the lung in healthy nonsmoking adults. Korean J Intern Med. 1986;1:178–84.PubMedPubMedCentralCrossRef
25.
Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54:581–6.PubMedPubMedCentralCrossRef
26.
Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Leidy NK. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34:648–54.PubMedCrossRef
27.
Shin S, Park HY, Kim H, Kim HK, Choi YS, Kim J, Um S-W, Chung MJ, Kim H, Kwon OJ, et al. Joint effect of airflow limitation and emphysema on postoperative outcomes in early-stage nonsmall cell lung cancer. Eur Respir J. 2016;48:1743.PubMedCrossRef
28.
Lima LN, da Silva RA, Gross JL, Deheinzelin D, Negri EM. Assessment of pulmonary function and quality of life in patients submitted to pulmonary resection for cancer. J Bras Pneumol. 2009;35:521–8.PubMedCrossRef
29.
Brunelli A, Socci L, Refai M, Salati M, Xiume F, Sabbatini A. Quality of life before and after major lung resection for lung cancer: a prospective follow-up analysis. Ann Thorac Surg. 2007;84:410–6.PubMedCrossRef
30.
Poghosyan H, Sheldon LK, Leveille SG, Cooley ME. Health-related quality of life after surgical treatment in patients with non-small cell lung cancer: a systematic review. Lung Cancer. 2013;81:11–26.PubMedCrossRef
31.
Balduyck B, Hendriks J, Lauwers P, Sardari Nia P, Van Schil P. Quality of life evolution after lung cancer surgery in septuagenarians: a prospective study. Eur J Cardiothorac Surg. 2009;35:1070–5.PubMedCrossRef
32.
Balduyck B, Hendriks J, Lauwers P, Van Schil P. Quality of life after lung cancer surgery: a prospective pilot study comparing bronchial sleeve lobectomy with pneumonectomy. J Thorac Oncol. 2008;3:604–8.PubMedCrossRef
33.
Burfeind WR Jr, Tong BC, O’Branski E, Herndon JE, Toloza EM, D’Amico TA, Harpole LH, Harpole DH Jr. Quality of life outcomes are equivalent after lobectomy in the elderly. J Thorac Cardiovasc Surg. 2008;136:597–604.PubMedCrossRef
34.
Kenny PM, King MT, Viney RC, Boyer MJ, Pollicino CA, McLean JM, Fulham MJ, McCaughan BC. Quality of life and survival in the 2 years after surgery for non small-cell lung cancer. J Clin Oncol. 2008;26:233–41.PubMedCrossRef
35.
Kim SJ, Lee YJ, Park JS, Cho YJ, Cho S, Yoon HI, Kim K, Lee JH, Jheon S, Lee CT. Changes in pulmonary function in lung cancer patients after video-assisted thoracic surgery. Ann Thorac Surg. 2015;99:210–7.PubMedCrossRef
36.
Balduyck B, Hendriks J, Lauwers P, Van Schil P. Quality of life evolution after lung cancer surgery: a prospective study in 100 patients. Lung Cancer. 2007;56:423–31.PubMedCrossRef
37.
Miserocchi G, Beretta E, Rivolta I. Respiratory mechanics and fluid dynamics after lung resection surgery. Thorac Surg Clin. 2010;20:345–57.PubMedCrossRef
38.
Sarna L, Evangelista L, Tashkin D, Padilla G, Holmes C, Brecht ML, Grannis F. Impact of respiratory symptoms and pulmonary function on quality of life of long-term survivors of non-small cell lung cancer. Chest. 2004;125:439–45.PubMedCrossRef
39.
Martinez TY, Pereira CA, dos Santos ML, Ciconelli RM, Guimaraes SM, Martinez JA. Evaluation of the short-form 36-item questionnaire to measure health-related quality of life in patients with idiopathic pulmonary fibrosis. Chest. 2000;117:1627–32.PubMedCrossRef
40.
Mahler DA, Faryniarz K, Tomlinson D, Colice GL, Robins AG, Olmstead EM, O’Connor GT. Impact of dyspnea and physiologic function on general health status in patients with chronic obstructive pulmonary disease. Chest. 1992;102:395–401.PubMedCrossRef
41.
Ruffin RE, Wilson DH, Chittleborough CR, Southcott AM, Smith B, Christopher DJ. Multiple respiratory symptoms predict quality of life in chronic lung disease: a population-based study of Australian adults. Qual Life Res. 2000;9:1031–9.PubMedCrossRef
42.
Avancini A, Sartori G, Gkountakos A, Casali M, Trestini I, Tregnago D, Bria E, Jones LW, Milella M, Lanza M, Pilotto S. Physical activity and exercise in lung cancer care: will promises be fulfilled? Oncologist. 2020;25:e555–69.PubMedCrossRef
43.
Codima A, das Neves Silva W, de Souza Borges AP, de Castro G, Jr.: Exercise prescription for symptoms and quality of life improvements in lung cancer patients: a systematic review. Support Care Cancer 2021, 29:445–457.
44.
Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003;80:99–103.PubMedCrossRef
45.
Goehring HJ. Statistical methods in education. Arlington: Information Resources Press; 1981.
Metadata
Title
Longitudinal changes in pulmonary function and patient-reported outcomes after lung cancer surgery
Authors
Sumin Shin
Sunga Kong
Danbee Kang
Genehee Lee
Jong Ho Cho
Young Mog Shim
Juhee Cho
Hong Kwan Kim
Hye Yun Park
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2022
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-022-02149-9

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