title: How best to assess the quality of life in long-term survivors after surgery for NSCLC? Comparison between clinical predictors and questionnaire scores.
abstract: BACKGROUND
  The determinants and predictors of QOL in lung cancer survivors who have received surgery remain defined vaguely and still debated. We evaluate clinical, surgical, and pulmonary function characteristics as predictors of QOL in long-term lung cancer survivors who received surgery.
  
  
  METHODS
  Quality of life was evaluated 5 years after surgery in 67 lung cancer patients using the European Organization for Research and Treatment of Cancer (EORTC) QOL Core Questionnaire, its lung cancer-specific module QLQ LC-13, and the Hospital Anxiety and Depression Scale questionnaire. Preoperative clinical, surgical, and pathologic data were matched with the questionnaire scores.
  
  
  RESULTS
  Sex was associated with role functioning and symptoms, with males more often reporting fatigue and pain, appetite loss, coughing, and hemoptysis (P < .05). Lower education was associated with better cognitive functioning (P < .05). Symptoms were worse for younger patients and for those with major comorbidity. Histology marginally influenced the global health status (P < .10) and the cognitive functioning (P < .05). Patients receiving complementary therapy more easily suffered from fatigue and insomnia (P < .05), and to a lesser extent from nausea and vomiting, constipation, and stress related to financial difficulties (P < .10). Higher values of forced expiratory volume at the first second (FEV(1)) and forced vital capacity (FVC) were significantly (P < .05) associated with a lower frequency of nausea and vomiting and appetite loss, while low percentage levels of FEV(1) and FVC were associated with lower global function and a greater severity of specific and nonspecific symptoms (P < .10 and P < .05).
  
  
  CONCLUSIONS
  Several preoperative features, particularly those reflecting pulmonary function, were moderately associated with QOL in long-term survivors and may be useful to address therapeutic strategies in lung cancer patients after surgery.
authors.affiliation: Department of Rehabilitative Medicine, Campus Biomedico University, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sterzi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cesario
authors.forename: Giacomo
authors.initials: G
authors.lastname: Cusumano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Corbo
authors.forename: Filippo
authors.initials: F
authors.lastname: Lococo
authors.forename: Barbara
authors.initials: B
authors.lastname: Biasotti
authors.forename: Luisa Maria
authors.initials: LM
authors.lastname: Lapenna
authors.forename: Giovanni
authors.initials: G
authors.lastname: Magrone
authors.forename: Valentina
authors.initials: V
authors.lastname: Dall'armi
authors.forename: Elisa
authors.initials: E
authors.lastname: Meacci
authors.forename: Venanzio
authors.initials: V
authors.lastname: Porziella
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonassi
authors.forename: Stefano
authors.initials: S
authors.lastname: Margaritora
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Granone
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000855:Anorexia / Q000209:etiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000523:psychology / Q000601:surgery*; D003071:Cognition; D000529:Complementary Therapies / Q000009:adverse effects; D003248:Constipation / Q000209:etiology; D003371:Cough / Q000209:etiology; D004522:Educational Status; D005221:Fatigue / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010146:Pain / Q000209:etiology; D011788:Quality of Life / Q000523:psychology; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D013315:Stress, Psychological / Q000191:economics / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014797:Vital Capacity; D014839:Vomiting / Q000209:etiology