Preoperative Lung Function is Associated with Patient Reported Outcomes After Lung Cancer Surgery.

BACKGROUND: Patient quality of life (QOL) is a critical outcomes measure in lung cancer surgery. Patient reported outcomes (PRO) provide valuable insight into the patient experience and allow measurement of pre- and post-operative QOL. Our objective was to determine which clinical factors predict differences in QOL, as measured by patient-reported physical function and pain intensity among patients undergoing minimally-invasive lung cancer surgery.

METHODS: PRO surveys assessing physical function and pain intensity were conducted using instruments from the NIH Patient Reported Outcome Measurement Information System (PROMIS). PRO surveys were administered to patients undergoing minimally-invasive lung cancer resections at preoperative, one and six month postoperative time points, in an academic institution. Linear mixed-effects regression models were constructed to assess the association between clinical variables on PRO scores over time.

RESULTS: A total of 123 patients underwent a thoracoscopic lung resection for cancer. Mean age of the cohort was 67±9.6, 43% were male, and 80% were Caucasian. When comparing clinical variables with PRO scores after surgery, lower DLCO was associated with significantly worse physical function (p<0.01) and greater pain intensity scores (p<0.01) at 6 months, with no differences identified at 1 month. No other studied clinical factor was associated with significant differences in PRO scores.

CONCLUSIONS: Low preoperative DLCO was associated with significant decreases in PRO following minimally-invasive lung cancer surgery. DLCO may be of utility in identifying patients who experience greater decline in QOL after surgery and for guiding surgical decision-making.