Quality of life and survival in the 2 years after surgery for non small-cell lung cancer.
OBJECTIVE
Although surgery for early-stage non-small-cell lung cancer (NSCLC) is known to have a substantial impact on health-related quality of life (HRQOL), there are few published studies about HRQOL in the longer term. This article examines HRQOL and survival in the 2 years after surgery.


METHODS
Patients with clinical stage I or II NSCLC (n = 173) completed HRQOL questionnaires before surgery, at discharge, 1 month after surgery, and then every 4 months for 2 years. HRQOL was measured with a generic cancer questionnaire (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC-QLQ] C30) and a lung cancer-specific questionnaire (EORTC QLQ-LC13). Data were analyzed to examine the impact of surgery and any subsequent therapy, and to describe the trajectories of those who remained disease free at 2 years and those with recurrent cancer diagnosed during follow-up.


RESULTS
Disease recurred within 2 years for 36% of patients and 2-year survival was 65%. Surgery substantially reduced HRQOL across all dimensions except emotional functioning. HRQOL improved in the 2 years after surgery for patients without disease recurrence, although approximately half continued to experience symptoms and functional limitations. For those with recurrence within 2 years, there was some early postoperative recovery in HRQOL, with subsequent deterioration across most dimensions.


CONCLUSIONS
Surgery had a substantial impact on HRQOL, and although many disease-free survivors experienced recovery, some lived with long-term HRQOL impairment. HRQOL generally worsened with disease recurrence. The study results are important for informed decision making and ongoing supportive care for patients with operable NSCLC.
Kenny
Patricia M
PM
Centre for Health Economics Research and Evaluation, University of Technology, Sydney, PO Box 123, Broadway, Sydney, New South Wales 2007, Australia.: patsy.kenny@chere.uts.edu.au
King
Madeleine T
MT
Viney
Rosalie C
RC
Boyer
Michael J
MJ
Pollicino
Christine A
CA
McLean
Jocelyn M
JM
Fulham
Michael J
MJ
McCaughan
Brian C
BC
D000368:Aged; D001315:Australia / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D008297:Male; D015233:Models, Statistical; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000523:psychology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate