Subjective and objective assessment of quality of life after chest wall resection.
OBJECTIVE
To date, quality of life (QoL) after extensive chest wall resection is not known. This study analyses QoL in long-term survivors after extensive resection.


METHODS
Retrospective analysis of 51 patients operated for non-small-cell lung cancer (NSCLC)/mediastinal tumour invading the chest wall, primary/secondary chest wall tumours. QoL and functional status of long-term survivors (>36 months) were studied using Borg scale, Mahler dyspnoea index, Functional Autonomy Measuring System (SMAF) and 36-item Short Form Health Survey (SF-36) questionnaire. Out of the 51 patients, pulmonary function tests were available before and after resection in 24 patients and were subjected to analysis.


RESULTS
Five-year survival was 50%, 26 patients survived>36 months. At follow-up, 22/28 deaths were cancer related. Compared to baseline, the reduction of flow expiratory volume in 1s (FEV1) and forced vital capacity (FVC) were 18% and 15%, respectively (p<0.001). The QoL study included 23 long-term survivors. A moderate/severe dyspnoea was present in 5/23 patients (21%). The SF-36 questionnaire revealed that, compared to controls, patients with chest wall resection experienced impaired QoL in physical functioning, in role physical, in body pain, in social functioning and in mental health. Objective measurements of pulmonary function correlated poorly with QoL, whereas subjective assessment of dyspnoea was significantly associated with QoL.


CONCLUSIONS
This study shows that long-term survivors after extensive chest wall resection experienced moderate impairments in several QoL subscales. As previously reported in patients after pulmonary resection, subjective assessment such as dyspnoea correlated well with patient-perceived QoL.
Heuker
David
D
Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc-UCL, Université Catholique de Louvain, Brussels, Belgium.
Lengele
Benoît
B
Delecluse
Véronique
V
Weynand
Birgit
B
Liistro
Giuseppe
G
Balduyck
Bram
B
Noirhomme
Philippe
P
Poncelet
Alain Jean
AJ
D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D004417:Dyspnea / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011594:Psychometrics; D011788:Quality of Life; D013899:Thoracic Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D035441:Thoracic Wall / Q000473:pathology*; D013908:Thoracotomy / Q000009:adverse effects / Q000534:rehabilitation*; D016896:Treatment Outcome