title: Patient-Reported Symptom Interference as a Measure of Postsurgery Functional Recovery in Lung Cancer.
abstract: Few empirical studies have combined the patient's perspective (patient-reported outcomes [PROs]) with clinical outcomes (risk for complications, length of hospital stay, return to planned treatment) to assess the effectiveness of treatment after thoracic surgery for early-stage non-small cell lung cancer (NSCLC).
  
  
  
  Quantitatively measure PROs to assess functional recovery postsurgery.
  
  
  
  Treatment-naïve patients (N = 72) with NSCLC who underwent either open thoracotomy or video-assisted thoracoscopic surgery (VATS) used the MD Anderson Symptom Inventory (MDASI) to report symptom interference with general activity, work, walking, mood, relations with others, and enjoyment of life for three months after surgery. Functional recovery was defined as interference scores returning to presurgery levels. The MDASI's sensitivity to change in functional recovery over time was evaluated via its ability to distinguish between surgical techniques.
  
  
  
  Interference scores increased sharply by Day 3 after surgery (all P < 0.001), then returned to baseline levels via different trajectories. Patients who had unscheduled clinic visits during the study period reported higher scores on all six MDASI interference items (all P < 0.05). Compared with the open-thoracotomy group, the VATS group returned more quickly to baseline interference levels for walking (18 vs. 43 days), mood (8 vs. 19 days), relations with others (4 vs. 16 days), and enjoyment of life (15 vs. 41 days) (all P < 0.05).
  
  
  
  Repeated measurement of MDASI interference characterized functional recovery after thoracic surgery for NSCLC and was sensitive to VATS' ability to enhance postoperative recovery. Further study of the clinical applicability of measuring recovery outcomes using PRO-based functional assessment is warranted.
authors: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Qiuling
authors: Q
authors: Shi
authors: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Electronic address: xswang@mdanderson.org.
authors: Xin Shelley
authors: XS
authors: Wang
authors: Department of Thoracic & Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Ara A
authors: AA
authors: Vaporciyan
authors: Department of Thoracic & Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: David C
authors: DC
authors: Rice
authors: Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Keyuri U
authors: KU
authors: Popat
authors: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Charles S
authors: CS
authors: Cleeland
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy
keywords: Postoperative care; VATS; outcomes; quality of care; symptom management; thoracoscopy; thoracotomy