Quality of life after lung cancer surgery: a prospective pilot study comparing bronchial sleeve lobectomy with pneumonectomy.
OBJECTIVE
To prospectively evaluate quality of life (QoL) evolution after sleeve lobectomy and pneumonectomy with the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire-C30 and LC-13.


METHODS
From January 2003 till December 2005, QoL was prospectively recorded after 10 sleeve lobectomies and 20 pneumonectomies. Questionnaires were administered before surgery and 1, 3, 6, and 12 months postoperatively (MPO) with response rates of 100%, 90.0%, 76.7%, 80.0% and 73.3%, respectively.


RESULTS
Sleeve lobectomy was characterized by a 1 month temporary decrease in physical and social functioning scores after surgery (1MPO p = 0.026 and p = 0.048, respectively). After sleeve lobectomy, quality of life scores approximated baseline preoperative values 1 month after surgery. In the 12 months follow-up period after pneumonectomy, there was no return to baseline in physical and role functioning (12MPO p = 0.001 and p = 0.011, respectively). Pneumonectomy patients reported a significant increase in postoperative dyspnea (1MPO p = 0.027, 6MPO p = 0.025, 12MPO 0.021), general pain (1MPO p = 0.006, 3MPO p = 0.008, 6MPO p = 0.005, 12MPO p = 0.036), thoracic pain (6MPO p = 0.019) and shoulder dysfunction (6MPO p = 0.04, 12MPO p = 0.026).Comparing both resections, significant differences in evolution of physical functioning (1MPO p = 0.014, 3MPO p = 0.008, 6MPO p = 0.004), role functioning (1MPO p = 0.041), cognitive functioning (6MPO p = 0.005, 12MPO p = 0.013) and shoulder dysfunction (12MPO p = 0.049) were reported in favor of sleeve lobectomy.


CONCLUSIONS
The high burden of dyspnea, general pain, thoracic pain and shoulder dysfunction reported after pneumonectomy, is not seen after sleeve lobectomy. In patients with anatomically appropriate early-stage lung cancer, sleeve lobectomy offers better quality of life than does pneumonectomy.
Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Edegem, Belgium. bram.balduyck@uza.be
Bram
B
Balduyck
Jeroen
J
Hendriks
Patrick
P
Lauwers
Paul
P
Van Schil
D000368:Aged; D001530:Belgium / Q000453:epidemiology; D001980:Bronchi / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods* / Q000523:psychology; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome