Preoperative symptom burden and quality of life of patients undergoing lung cancer surgery: A cross-sectional study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Chuanmei ¹ , ZHOU Heling ¹ , JIANG Yanhua ¹ , YANG Fan ¹ , FENG Yaqian ¹ , WEI Xing ¹ , XIE Shaohua ^1,2 , HE Jintao ¹ , LI Qiang ¹ , SHI Qiuling ^1,3 ,  DAI Wei ¹

1. Department of Thoracic Surgery, Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P.R.China;
2. Graduate School, Chengdu Medical College, Chengdu, 610500, P.R.China;
3. Chongqing Medical University, Chongqing, 400016, P.R.China;

Corresponding?author：

DAI Wei, Email: daiwei@sichuancancer.org

Keywords：

Lung cancer; surgery; symptom; quality of life; patient-reported outcome

DOI：

10.7507/1007-4848.201908057

Video：

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ObjectiveTo investigate the preoperative symptom burden and quality of life of patients undergoing lung cancer surgery.MethodsThis study was a cross-sectional study. We used the MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) and the single-item quality of life scale (UNISCALE) to collect the preoperative patient-reported outcomes of 265 patients with lung cancer from November 2017 to July 2019 in Sichuan Cancer Hospital.ResultsOf 265 patients, 90.9% had preoperative symptoms. The five most common symptoms were coughing (66.8%), dry mouth (53.6%), memory problems (52.8%), disturbed sleep (52.1%) and fatigue (44.2%). The five most common moderate to severe symptoms were disturbed sleep (23.0%), distress (18.5%), memory problems (16.6%), coughing (16.2%) and dry mouth (16.2%). Patients with early-stage lung cancer had less pain, fatigue, shortness of breath, lack of appetite, numbness and coughing, and their symptoms had less impact on work (including housework), relations with other people, walking and enjoyment of life as well as better quality of life before surgery (P<0.05). Patients with adenocarcinoma had milder coughing and a better quality of life before surgery (P<0.05). Symptom score was positively correlated with symptom interference with life score (r=0.66, P<0.01) and negatively correlated with quality of life score (r=-0.41, P<0.01).ConclusionMost patients undergoing lung cancer surgery have a mild symptom burden before surgery. The most common and severe symptoms are coughing, dry mouth, lung cancer and disturbed sleep. Patients with early-stage lung cancer have a milder symptom burden and a better quality of life.

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2.	Basch E. Patient-Reported Outcomes - Harnessing Patients' Voices to Improve Clinical Care. N Engl J Med, 2017, 376(2): 105-108.
3.	Khullar OV, Fernandez FG. Patient-Reported Outcomes in Thoracic Surgery. Thorac Surg Clin, 2017, 27(3): 279-290.
4.	邵茜茜, 劉東英. 肺癌患者肺葉切除術后癥狀群調查研究. 護理學報, 2018, 25(18): 1-4.
5.	姜男, 陳小岑, 趙岳. 肺癌患者同步放化療期間癥狀群的調查研究. 中國全科醫學, 2012, 15(33): 3866-3869.
6.	李楠楠, 陳芬榮, 朱惠瑛, 等. 肺癌患者化療前后癥狀群的調查研究. 解放軍護理雜志, 2017, 34(23): 34-38.
7.	魏婷婷, 陳小岑, 侯云霞, 等. 肺癌化療患者癌因性失眠及腫瘤相關癥狀調查研究. 中國全科醫學, 2015, (21): 2564-2567, 2572.
8.	萬光明, 張云, 王懿, 等. 163 例肺癌病人癥狀調查研究及分析. 護理研究, 2011, 25(21): 1896-1898.
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10.	Silvoniemi M, Vasankari T, L?yttyniemi E, et al. Symptom Assessment for Patients with Non-small Cell Lung Cancer Scheduled for Chemotherapy. Anticancer Res, 2016, 36(8): 4123-4128.
11.	Mendoza TR, Wang XS, Lu C, et al. Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. Oncologist, 2011, 16(2): 217-227.
12.	Spitzer WO, Dobson AJ, Hall J, et al. Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. J Chronic Dis, 1981, 34(12): 585-597.
13.	Sloan JA, Loprinzi CL, Kuross SA, et al. Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. J Clin Oncol, 1998, 16(11): 3662-3673.
14.	Harvey LA. REDCap: web-based software for all types of data storage and collection. Spinal Cord, 2018, 56(7): 625.
15.	Mendoza TR, Kehl KL, Bamidele O, et al. Assessment of baseline symptom burden in treatment-na?ve patients with lung cancer: an observational study. Support Care Cancer, 2019, 27(9): 3439-3447.
16.	Pompili C, Velikova G, White J, et al. Poor preoperative patient-reported quality of life is associated with complications following pulmonary lobectomy for lung cancer. Eur J Cardiothorac Surg, 2017, 51(3): 526-531.
17.	Zabora J, BrintzenhofeSzoc K, Curbow B, et al. The prevalence of psychological distress by cancer site. Psychooncology, 2001, 10(1): 19-28.
18.	Fagundes CP, Shi Q, Vaporciyan AA, et al. Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory. J Thorac Cardiovasc Surg, 2015, 150(3): 613-619.
19.	臧瑜, 于虹, 李妍, 等. 肺癌患者癥狀群的調查研究. 中華護理雜志, 2016, 51(3): 316-320.
20.	Lee K, Oh EG, Kim S, et al. Symptom experiences and health-related quality of life among non-small cell lung cancer patients participating in clinical trials. J Clin Nurs, 2019, 28(11-12): 2111-2123.
21.	Sloan JA, Zhao X, Novotny PJ, et al. Relationship between deficits in overall quality of life and non-small-cell lung cancer survival. J Clin Oncol, 2012, 30(13): 1498-1504.
22.	Yue J, Shi Q, Xu T, et al. Patient-reported lung symptoms as an early signal of impending radiation pneumonitis in patients with non-small cell lung cancer treated with chemoradiation: an observational study. Qual Life Res, 2018, 27(6): 1563-1570.
23.	Edbrooke L, Aranda S, Granger CL, et al. Multidisciplinary home-based rehabilitation in inoperable lung cancer: a randomised controlled trial. Thorax, 2019, 74(8): 787-796.
24.	Bouazza YB, Chiairi I, El Kharbouchi O, et al. Patient-reported outcome measures (PROMs) in the management of lung cancer: A systematic review. Lung Cancer, 2017, 113: 140-151.
25.	張昕, 邢鐠元, 郝學志, 等. 500 例肺癌患者首診癥狀及其影響因素分析. 中國肺癌雜志, 2018, 21(5): 408-412.
26.	張立力, 臧瑜. MD 安德森癥狀評估量表肺癌模塊的修訂和考評. 腫瘤, 2013, 33(5): 434-438.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Basch E. Patient-Reported Outcomes - Harnessing Patients' Voices to Improve Clinical Care. N Engl J Med, 2017, 376(2): 105-108.
3. Khullar OV, Fernandez FG. Patient-Reported Outcomes in Thoracic Surgery. Thorac Surg Clin, 2017, 27(3): 279-290.
4. 邵茜茜, 劉東英. 肺癌患者肺葉切除術后癥狀群調查研究. 護理學報, 2018, 25(18): 1-4.
5. 姜男, 陳小岑, 趙岳. 肺癌患者同步放化療期間癥狀群的調查研究. 中國全科醫學, 2012, 15(33): 3866-3869.
6. 李楠楠, 陳芬榮, 朱惠瑛, 等. 肺癌患者化療前后癥狀群的調查研究. 解放軍護理雜志, 2017, 34(23): 34-38.
7. 魏婷婷, 陳小岑, 侯云霞, 等. 肺癌化療患者癌因性失眠及腫瘤相關癥狀調查研究. 中國全科醫學, 2015, (21): 2564-2567, 2572.
8. 萬光明, 張云, 王懿, 等. 163 例肺癌病人癥狀調查研究及分析. 護理研究, 2011, 25(21): 1896-1898.
9. Shallwani SM, Simmonds MJ, Kasymjanova G, et al. Quality of life, symptom status and physical performance in patients with advanced non-small cell lung cancer undergoing chemotherapy: an exploratory analysis of secondary data. Lung Cancer, 2016, 99: 69-75.
10. Silvoniemi M, Vasankari T, L?yttyniemi E, et al. Symptom Assessment for Patients with Non-small Cell Lung Cancer Scheduled for Chemotherapy. Anticancer Res, 2016, 36(8): 4123-4128.
11. Mendoza TR, Wang XS, Lu C, et al. Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. Oncologist, 2011, 16(2): 217-227.
12. Spitzer WO, Dobson AJ, Hall J, et al. Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. J Chronic Dis, 1981, 34(12): 585-597.
13. Sloan JA, Loprinzi CL, Kuross SA, et al. Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. J Clin Oncol, 1998, 16(11): 3662-3673.
14. Harvey LA. REDCap: web-based software for all types of data storage and collection. Spinal Cord, 2018, 56(7): 625.
15. Mendoza TR, Kehl KL, Bamidele O, et al. Assessment of baseline symptom burden in treatment-na?ve patients with lung cancer: an observational study. Support Care Cancer, 2019, 27(9): 3439-3447.
16. Pompili C, Velikova G, White J, et al. Poor preoperative patient-reported quality of life is associated with complications following pulmonary lobectomy for lung cancer. Eur J Cardiothorac Surg, 2017, 51(3): 526-531.
17. Zabora J, BrintzenhofeSzoc K, Curbow B, et al. The prevalence of psychological distress by cancer site. Psychooncology, 2001, 10(1): 19-28.
18. Fagundes CP, Shi Q, Vaporciyan AA, et al. Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory. J Thorac Cardiovasc Surg, 2015, 150(3): 613-619.
19. 臧瑜, 于虹, 李妍, 等. 肺癌患者癥狀群的調查研究. 中華護理雜志, 2016, 51(3): 316-320.
20. Lee K, Oh EG, Kim S, et al. Symptom experiences and health-related quality of life among non-small cell lung cancer patients participating in clinical trials. J Clin Nurs, 2019, 28(11-12): 2111-2123.
21. Sloan JA, Zhao X, Novotny PJ, et al. Relationship between deficits in overall quality of life and non-small-cell lung cancer survival. J Clin Oncol, 2012, 30(13): 1498-1504.
22. Yue J, Shi Q, Xu T, et al. Patient-reported lung symptoms as an early signal of impending radiation pneumonitis in patients with non-small cell lung cancer treated with chemoradiation: an observational study. Qual Life Res, 2018, 27(6): 1563-1570.
23. Edbrooke L, Aranda S, Granger CL, et al. Multidisciplinary home-based rehabilitation in inoperable lung cancer: a randomised controlled trial. Thorax, 2019, 74(8): 787-796.
24. Bouazza YB, Chiairi I, El Kharbouchi O, et al. Patient-reported outcome measures (PROMs) in the management of lung cancer: A systematic review. Lung Cancer, 2017, 113: 140-151.
25. 張昕, 邢鐠元, 郝學志, 等. 500 例肺癌患者首診癥狀及其影響因素分析. 中國肺癌雜志, 2018, 21(5): 408-412.
26. 張立力, 臧瑜. MD 安德森癥狀評估量表肺癌模塊的修訂和考評. 腫瘤, 2013, 33(5): 434-438.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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