Thoracotomy and VATS Surgery in Local Non-Small-Cell Lung Cancer : Differences in Long-Term Health-Related Quality Of Life

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Rauma , V , Andersson , S , Robinson , E M , Rasanen , J , Sintonen , H , Salo , J A & Ilonen , I K 2019 , ' Thoracotomy and VATS Surgery in Local Non-Small-Cell Lung Cancer : Differences in Long-Term Health-Related Quality Of Life ' , Clinical Lung Cancer , vol. 20 , no. 5 , pp. 378-383 . https://doi.org/10.1016/j.cllc.2019.05.010

Title: Thoracotomy and VATS Surgery in Local Non-Small-Cell Lung Cancer : Differences in Long-Term Health-Related Quality Of Life
Author: Rauma, Ville; Andersson, Saana; Robinson, Eric M.; Rasanen, Jari; Sintonen, Harri; Salo, Jarmo A.; Ilonen, Ilkka K.
Contributor: University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Department of Surgery
Date: 2019-09
Language: eng
Number of pages: 6
Belongs to series: Clinical Lung Cancer
ISSN: 1525-7304
URI: http://hdl.handle.net/10138/312924
Abstract: Very long-term health-related quality of life (HRQoL) is an important end point in operated early stage non-small-cell lung cancer with good prognosis. The results for very long-term HRQoL after minimally invasive video-assisted thoracoscopic surgery (VATS) has not been evaluated and compared to thoracotomy. Surprisingly, inferior overall HRQoL was evident for patients operated with VATS, independent of preoperative factors including age, comorbidities, and pulmonary function tests. Background: As a result of routine low-dose computed tomographic screening, lung cancer is more frequently diagnosed at earlier, operable stages of disease. In treating local non-small-cell lung cancer, video-assisted thoracoscopic surgery (VATS), a minimally invasive surgical approach, has replaced thoracotomy as the standard of care. While short-term quality-of-life outcomes favor the use of VATS, the impact of VATS on long-term health-related quality of life (HRQoL) is unknown. Patients and Methods: We studied patients who underwent lobectomy for the treatment of non-small-cell lung cancer from January 2006 to January 2013 at a single institution (n = 456). Patients who underwent segmentectomy (n = 27), who received neoadjuvant therapy (n = 13), or who were found to have clinical stage > T2 or > NO disease (n = 45) were excluded from analysis. At time of HRQoL assessment, 199 patients were eligible for study and were mailed the generic HRQoL instrument 15D. Results: A total of 180 patients (90.5%) replied; 92 respondents underwent VATS while 88 underwent open thoracotomy. The VATS group more often had adenocarcinoma (P = .006), and lymph node stations were sampled to a lesser extent (P = .004); additionally, hospital length of stay was shorter among patients undergoing VATS (P = .001). No other clinical or pathologic differences were observed between the 2 groups. Surprisingly, patients who underwent VATS scored significantly lower on HRQoL on the dimensions of breathing, speaking, usual activities, mental function, and vitality, and they reported a lower total 15D score, which reflects overall quality of life (P <.05). Conclusion: In contrast to earlier short-term reports, long-term quality-of-life measures are worse among patients who underwent VATS compared to thoracotomy. (C) 2019 Elsevier Inc. All rights reserved.
Subject: 15D
NSCLC
ASSISTED THORACIC-SURGERY
OPEN LOBECTOMY
THORACOSCOPIC LOBECTOMY
PULMONARY-FUNCTION
COMORBIDITY INDEX
MORTALITY
RESECTION
OUTCOMES
SOCIETY
3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
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